| NPI | 1992078661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN KELLY CUTTING Program Manager 339-440-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NH 3280) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |