NPI | 1659555761 |
---|---|
Doing Business As | EXTENDED CARE FACILITY |
Entity Type | Organization |
Authorized Contact | TINA RENE VEST Billing Manager 662-625-7111 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MS 1054) |
Enumeration Date | 2007-12-26 |
Last Update Date | 2022-07-14 |