Organization
SAMARITAN GARDEN PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA PULLIAM SATTERWHITE (ADMINISTRATOR)
(662) 566-9974
Entity
Organization
Contact information
Practice address
2603 S GLOSTER ST, TUPELO, MS 38801-6903
(662) 566-9974
Mailing address
2603 S GLOSTER ST, TUPELO, MS 38801-6903
(662) 566-9974
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
876
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770422
—
MS
Enumeration date
02/22/2007
Last updated
12/11/2007
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