Organization
DYNAMIC NATCHEZ OPERATING COMPANY LLC
Active
Other names
Trace Haven Health & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI M HODGE (BUSINESS OFFICE MANAGER)
(601) 442-4393
Entity
Organization
Contact information
Practice address
344 ARLINGTON AVENUE, NATCHEZ, MS 39120-3551
(601) 442-4393
(601) 446-8909
Mailing address
344 ARLINGTON AVENUE, NATCHEZ, MS 39120-3551
(601) 442-4393
(601) 446-8909
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
513
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230073
—
MS
Enumeration date
02/21/2007
Last updated
08/22/2020
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