| NPI | 1063188035 |
|---|---|
| Doing Business As | SOUTHAVEN |
| Entity Type | Organization |
| Authorized Contact | SCOTT COLE Owner 573-217-8669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-10-25 |