| NPI | 1992034557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH NIELSON Manager 407-247-2788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OH 1140-N) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2018-04-19 |