| NPI | 1689603755 |
|---|---|
| Doing Business As | MISSION CONVALESCENT HOME |
| Entity Type | Organization |
| Authorized Contact | DUANE CHERRY Administrator 731-424-2951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0445447) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 0000175) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2012-02-08 |