Organization
PERRY COMMUNITY CARE CENTER LLC
Active
Other names
Perry County Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONI PARKINSON (AUTHORIZED REPRESENTATIVE)
(601) 709-1408
Entity
Organization
Contact information
Practice address
202 BAY AVE, RICHTON, MS 39476-2941
(601) 788-2490
(601) 788-2499
Mailing address
202 BAY AVE, RICHTON, MS 39476-2941
(601) 788-2490
(601) 788-2499
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
650
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230159
—
MS
01
—
80115
BLUE CROSS BLUE SHIELD
MS
Enumeration date
05/05/2006
Last updated
10/28/2015
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