| NPI | 1982033551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILLE DENISE RUDOLPH RN 251-288-1973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: AL 1-121390) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |