Organization
PROVIDENCE PCC OF SENATOBIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE ISAACKS (DIRECTOR)
(662) 562-9229
Entity
Organization
Contact information
Practice address
700 MOORES XING, SENATOBIA, MS 38668-8004
(662) 562-9229
(662) 562-9202
Mailing address
700 MOORES XING, SENATOBIA, MS 38668-8004
(662) 562-9229
(662) 562-9202
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1032
MS
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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