| NPI | 1962041798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JETUWAN M BROWN Managing Officer 601-278-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |