| NPI | 1942636998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARKE DANIEL PEPPER Executive Director 662-366-6920 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MS 1074) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2016-03-02 |