| NPI | 1265420152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH RAE MILLER Administrator 601-649-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 564) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-08-22 |