Organization
METHODIST HOME ROAD LIVING CENTER
Active
Parent organization
METHODIST HOME ROAD LIVING CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
METHODIST HOME ROAD LIVING CENTER
Authorized official
MRS. PEBLES JONES-WRIGHT (MANAGER/OWNER)
(769) 257-7232
Entity
Organization
Contact information
Practice address
4560 METHODIST HOME ROAD, JACKSON, MS 39213
(769) 257-7232
(769) 257-7745
Mailing address
4560 METHODIST HOME ROAD, JACKSON, MS 39213
(769) 257-7232
(769) 257-7745
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P321453
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078890066
DUNS
MS
Enumeration date
08/13/2013
Last updated
08/13/2013
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