| NPI | 1750431391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LOGAN Administrator 601-855-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 187) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2010-03-23 |