Organization
CLEVELAND PCH RESIDENTIAL LIVING, LLC
Active
Other names
Cleveland Personal Care Community
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN P YOUNG (EXECUTIVE DIRECTOR)
(662) 846-6160
Entity
Organization
Contact information
Practice address
800 THIRD STREET, CLEVELAND, MS 38732
(662) 846-6160
(662) 846-6164
Mailing address
800 THIRD STREET, CLEVELAND, MS 38732
(662) 846-6160
(662) 846-6164
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
978
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08073094
—
MS
Enumeration date
01/16/2007
Last updated
12/26/2007
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