| NPI | 1205904604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZIE LASSITER Director Of Facility 601-477-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MS 284) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |