Organization
NEURO REHABCARE-TASS
Active
Other names
NRC-TASS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF STANFORD M.A. (DIRECTOR)
(601) 892-4384
Entity
Organization
Contact information
Practice address
512 HARMONY ROAD, CRYSTAL SPRINGS, MS 39059
(601) 892-4384
(601) 892-4386
Mailing address
512 HARMONY ROAD, CRYSTAL SPRINGS, MS 39059
(601) 892-4384
(601) 892-4386
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01
STATE LICENSE
MS
Enumeration date
03/15/2019
Last updated
03/15/2019
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