| NPI | 1366584708 |
|---|---|
| Other Name | HATTIESBURG CONVALESCENT CENTER |
| Entity Type | Organization |
| Authorized Contact | JEWELL C MCMAHAN Administrator 601-544-4230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS 0017704.1) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MS 25) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |