Organization
MOCKINGBIRD ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD JOE GROOMS (ADMINISTRATOR)
(662) 596-3030
Entity
Organization
Contact information
Practice address
1101 W CHAMBERS DR, BOONEVILLE, MS 38829-6840
(662) 416-5469
(662) 596-3052
Mailing address
1101 W CHAMBERS DR, BOONEVILLE, MS 38829-6840
(662) 416-5469
(662) 596-3052
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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