| NPI | 1841715539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOPE ELIZABETH WILLIAMS Interim Administrator 662-374-5028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2021-02-18 |