| NPI | 1457341976 |
|---|---|
| Doing Business As | TISHOMINGO COMMUNITY LIVING CENTER |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS M. WRIGHT Managing Member 662-680-3148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 643) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2008-01-28 |