Shady Lawn, Llc

NPI 1184613143 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1184613143
Enumeration Date 10/20/2005
Last Updated 01/21/2015
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name WILLIAM D. WILLIAM
Position CEO
Phone (601) 636-1448
Fax (601) 636-8811
Practice Location
60 SHADY LAWN PL
VICKSBURG MS, 39180-4588, US
Phone (601) 636-1448
Fax (601) 636-8811
Business Location
6 CADILLAC DR
SUITE 310
BRENTWOOD TN, 37027-5080, US
Phone (615) 250-7100
Fax (615) 250-7102
Toxanomy
Taxonomy Code 314000000X
License State Mississippi
License Number 182
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According to our database, Shady Lawn, Llc NPI is 1184613143, taxonomy code is 314000000X and license number is 182, license state is located at Mississippi. Shady Lawn, Llc physically located at 60 Shady Lawn Pl, Vicksburg MS, 39180-4588. NPI Number 1033115704 has the healthcare provider type.

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1184613143 NPI number is provided on an as is basis without warranty of any kind. 1184613143 is maintained by the National Plan & Provider Enumeration System. The contents of Shady Lawn, Llc are for informational purposes only.