| NPI | 1780096586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN LAVERNE MONCRIEF Owner/Operator 601-946-9562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |