| NPI | 1033508809 |
|---|---|
| Doing Business As | ASSISTED/EXTENDED STAY FACILITY |
| Entity Type | Organization |
| Authorized Contact | BEATRICE A EZEM CEO 601-927-9839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2015-01-17 |
| Last Update Date | 2015-01-17 |