| NPI | 1689897795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON DIRK GODDARD Ar Manager 601-824-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 855) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-12-05 |