| NPI | 1679134183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA JEAN SHOULDERS Owner 601-831-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |