Organization
CLC OF MERIDIAN, LLC
Active
Other names
Meridian Community Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER)
(662) 680-3148
Entity
Organization
Contact information
Practice address
517 33RD ST, MERIDIAN, MS 39305-3944
(601) 483-3916
(601) 483-3965
Mailing address
517 33RD ST, MERIDIAN, MS 39305-3944
(601) 483-3916
(601) 483-3965
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
609
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230183
—
MS
Enumeration date
10/25/2005
Last updated
01/28/2008
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