| NPI | 1356587208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LOUISE ELLIS Comptroller 601-304-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 562) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2008-12-24 |