Organization
SMITH COUNTY LTC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA NELL EUBANKS CONTROLLER (CONTROLLER)
(662) 234-1520
Entity
Organization
Contact information
Practice address
309 MAGNOLIA DRIVE, RALEIGH, MS 39153
(601) 782-4244
(601) 782-9616
Mailing address
309 MAGNOLIA DRIVE, P. O. BOX 128, RALEIGH, MS 39153
(601) 782-4244
(601) 782-9616
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
354
MS
Other
Enumeration date
03/07/2007
Last updated
10/28/2014
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