| NPI | 1386940666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JEAN VEGA Physical Therapist Assistant 662-574-1664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MS PTA4054) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2011-02-02 |