Organization
NC LEASING, LLC
Active
Other names
The Nichols Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ROTOLO (MEMBER)
(601) 853-2667
Entity
Organization
Contact information
Practice address
1308 HIGHWAY 51, MADISON, MS 39110-7205
(601) 853-4343
(601) 853-9691
Mailing address
PO BOX 2712, RIDGELAND, MS 39158-2712
(601) 853-2667
(601) 853-2116
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
12
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07626880
—
MS
Enumeration date
11/20/2006
Last updated
02/20/2008
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