Indywood Llc

NPI 1205908670 - Assisted Living Facility - 310400000X

NPI Details
NPI 1205908670
Enumeration Date 11/14/2006
Last Updated 09/16/2009
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name ELETA J ELETA
Position OWNER
Phone (662) 887-3005
Fax
Practice Location
541 DORSETT DR
INDIANOLA MS, 38751-2386, US
Phone (662) 887-3005
Fax
Business Location
541 DORSETT DR
INDIANOLA MS, 38751-2386, US
Phone (662) 887-3005
Fax
Toxanomy
Taxonomy Code 310400000X
License State Mississippi
License Number 838
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According to our database, Indywood Llc NPI is 1205908670, taxonomy code is 310400000X and license number is 838, license state is located at Mississippi. Indywood Llc physically located at 541 Dorsett Dr, Indianola MS, 38751-2386. NPI Number 1033115704 has the healthcare provider type.

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1205908670 NPI number is provided on an as is basis without warranty of any kind. 1205908670 is maintained by the National Plan & Provider Enumeration System. The contents of Indywood Llc are for informational purposes only.