| NPI | 1740668755 |
|---|---|
| Other Name | BROADWAY MANOR RESIDENTIAL CAREHOME |
| Entity Type | Organization |
| Authorized Contact | JMELBA H THOMPSON Director 662-702-5007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MS 1096) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-07-24 |