| NPI | 1649595349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HIGGINS Board President 662-285-6329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MS 242) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2010-04-06 |