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Organization

MISSISSIPPI STATE HOSPITAL

Active
Other names
Jaquith Nursing Home - Washington Inn
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES G CHASTAIN (DIRECTOR)
(601) 351-8000
Entity
Organization

Contact information

Practice address
3550 HIGHWAY 468 W, PEARL, MS 39208-5529
(601) 351-8000
(601) 351-8301
Mailing address
PO BOX 157A, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8301

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
939
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00230123
MS
Enumeration date
10/17/2006
Last updated
11/29/2010
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