| NPI | 1184611741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTINA FLETCHER BOLTON Administrator 601-786-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 711) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2008-04-15 |