Organization
CLAIBORNE COUNTY SENIOR CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA ELLIS (COMPTROLLER)
(601) 304-0980
Entity
Organization
Contact information
Practice address
2124 OLD HIGHWAY 61 S, PORT GIBSON, MS 39150-2589
(601) 437-8737
(601) 437-8724
Mailing address
2124 OLD HIGHWAY 61 S, P O BOX 1018, PORT GIBSON, MS 39150-2589
(601) 437-8737
(601) 437-8724
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
679
MS
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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