Organization
MS GREENBOUGH LLC
Active
Parent organization
GULF COAST FACILITIES LLC
Other names
Greenbough Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GULF COAST FACILITIES LLC
Authorized official
JAMES RICHARDSON (PRESIDENT)
(850) 430-0000
Entity
Organization
Contact information
Practice address
340 DESOTO AVENUE EXT, CLARKSDALE, MS 38614-2814
(662) 627-3486
Mailing address
40 PALAFOX PL, SUITE 400, PENSACOLA, FL 32502-5697
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/09/2008
Last updated
10/05/2015
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