NPI | 1679943310 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA COURTNEY Administrator 601-624-0311 |
Organization Subpart ? | Yes |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
Enumeration Date | 2015-10-06 |
Last Update Date | 2015-10-06 |