| NPI | 1144577339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN TROY BOUTIN President 662-840-0535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MS PT4554) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-09-26 |