| NPI | 1992915607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BOLEWARE Administrator 601-795-4543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 275N00000X Medicare Defined Swing Bed Unit (Licence: MS 21087) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2011-09-02 |