Organization
DYNAMIC YAZOO CITY OPERATING COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENA JOHNSON (ADMINISTRATOR ASST.)
(662) 746-6651
Entity
Organization
Contact information
Practice address
925 CALHOUN AVE, YAZOO CITY, MS 39194-3229
(662) 746-6651
(662) 746-6090
Mailing address
925 CALHOUN AVE, YAZOO CITY, MS 39194-3229
(662) 746-6651
(662) 746-6090
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230074
—
MS
Enumeration date
02/20/2007
Last updated
08/22/2020
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