NPI | 1205823812 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBORAH GWIN WHITE Administrator 662-773-8047 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 562) |
Enumeration Date | 2005-09-29 |
Last Update Date | 2008-06-19 |