Organization
SHANELL'S RESIDENTIAL CARE HOME, INC.
Active
Other names
Shanell's Residential Care Home, Inc. (Assistant Living)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARNELL KITCHENS (PRESIDENT)
(601) 259-4602
Entity
Organization
Contact information
Practice address
4022 CALIFORNIA AVE, JACKSON, MS 39213-5513
(601) 362-4549
Mailing address
PO BOX 83040, JACKSON, MS 39283-3040
(601) 362-4549
(601) 713-3513
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1035
MS
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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