| NPI | 1659556371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERROLYNN EDWARDS Administrator 601-695-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MS 251QA0600X) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MS 172A00000X) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MS 376J00000X) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |