| NPI | 1164845210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EARL SILAS Owner 601-960-7426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MS 311ZA0620X) |
| Enumeration Date | 2014-01-26 |
| Last Update Date | 2014-01-26 |