NPI | 1598749210 |
---|---|
Entity Type | Organization |
Authorized Contact | TINA L ELLIS Com PT Roller 601-304-0980 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 375) |
Enumeration Date | 2005-12-06 |
Last Update Date | 2010-02-03 |