| NPI | 1912061185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI REYNOLDS Administrator 662-287-8071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 914) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2008-11-06 |