| NPI | 1336136241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY SHEA MARTIN Executive Director 662-494-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 178) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2020-08-22 |