Organization
COMMUNITY PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE-MICHELLE SABATHIER DANIEL NHA, MHA (ADMINISTRATOR)
(601) 355-0617
Entity
Organization
Contact information
Practice address
1129 LANGLEY AVE, JACKSON, MS 39204-3115
(601) 355-0617
(601) 948-7506
Mailing address
1129 LANGLEY AVE, JACKSON, MS 39204-3115
(601) 355-0617
(601) 948-7506
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
53
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023034
—
MS
Enumeration date
10/02/2006
Last updated
08/22/2020
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