Organization
PROVIDENCE PCC OF BATESVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT R GUNTER (DIRECTOR)
(662) 563-2345
Entity
Organization
Contact information
Practice address
640 KEATING RD, BATESVILLE, MS 38606-8301
(662) 563-2345
Mailing address
PO BOX 1632, BATESVILLE, MS 38606-4132
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
879
MS
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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