| NPI | 1265741300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R WILSON Executive Director 662-773-8721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MS 946) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MS 946) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |