Organization
BAPTIST-LEAKE EXTENDED CARE FACILITY
Active
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAPTIST MEMORIAL HEALTH CARE CORP.
Authorized official
GREGORY M DUCKETT (SR VP/ CLO)
(901) 227-5233
Entity
Organization
Contact information
Practice address
310 ELLIS ST, CARTHAGE, MS 39051-3809
(601) 267-1432
(601) 267-1211
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(601) 267-1432
(601) 267-1211
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
214
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230186
—
MS
Enumeration date
11/01/2011
Last updated
09/30/2020
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