| NPI | 1700367174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RICE Executive Director 662-295-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 385H00000X Respite Care | |
| 251C00000X | |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2022-10-11 |