Organization
INDYWOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELETA J GRIMMETT (OWNER)
(662) 534-2387
Entity
Organization
Contact information
Practice address
541 DORSETT DR, INDIANOLA, MS 38751-2386
(662) 887-3005
Mailing address
541 DORSETT DR, INDIANOLA, MS 38751-2386
(662) 887-3005
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
838
MS
Other
Enumeration date
11/14/2006
Last updated
09/16/2009
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