| NPI | 1366870909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI COX Nurse Practitioner 662-296-2451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MS R860656) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-30 |