| Name | Value |
|---|---|
| PROVIDER TYPE | Nursing & Custodial Care Facilities |
| CLASSIFICATION | Skilled Nursing Facility |
| DEFINITION | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| AREA OF SPECIALIZATION | Nursing Care, Pediatric |
| STATUS | Active |
| X12 CODE | 3140N1450X |
| INDIVIDUAL/NON | NON-INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252774 |
| EFFECTIVE DATE/TIME |
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