| NPI | 1407179039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY JORDAN Owner 601-624-0315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2010-05-18 |