| NPI | 1245434109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON DIRK GODDARD Ar Manager 601-824-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MS 672) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |