Organization
LAMAR COMMUNITY CARE CENTER LLC
Active
Other names
Windham House of Hattiesburg
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONI PARKINSON (AUTHORIZED REPRESENTATIVE)
(601) 709-1408
Entity
Organization
Contact information
Practice address
37 HILLCREST DR, HATTIESBURG, MS 39402-8625
(601) 264-0058
(601) 264-7329
Mailing address
37 HILLCREST DR, HATTIESBURG, MS 39402-8625
(601) 264-0058
(601) 264-7329
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
900
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04473558
—
MS
01
—
80394
BLUE CROSS BLUE SHIELD
MS
Enumeration date
05/04/2006
Last updated
04/30/2013
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