| NPI | 1194773515 |
|---|---|
| Doing Business As | TISHOMINGO MANOR |
| Entity Type | Organization |
| Authorized Contact | TONI PARKINSON Authorized Representative 601-709-1408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 414) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-04-30 |