| NPI | 1912455361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JEAN BEN C.E. O. 601-209-4278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 314000000X Skilled Nursing Facility | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| 332U00000X Home Delivered Meals | |
| 343800000X Secured Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |