Organization
KEMPER COUNTY LTC INC
Active
Other names
Mississippi Care Center of DeKalb LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY C NESTER NHA (ADMINISTRATOR)
(601) 743-5888
Entity
Organization
Contact information
Practice address
220 WILLOW AVE, DEKALB, MS 39328-0577
(601) 743-5888
(601) 743-4506
Mailing address
PO BOX 577, DE KALB, MS 39328-0577
(601) 743-5888
(601) 743-4506
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
358
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230087
—
MS
Enumeration date
10/25/2005
Last updated
08/22/2020
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