| NPI | 1982723904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL BLALACK Administrator 731-221-2402 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 275N00000X Medicare Defined Swing Bed Unit (Licence: TN 00000088) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2009-07-15 |