Organization
PREFERRED CARE DEVELOPMENTAL CENTERS OF MS I INC
Active
Other names
Canton Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMIE LATTURE COLLIER (DIRECTOR OF REIMBURSEMENT)
(972) 931-3800
Entity
Organization
Contact information
Practice address
1145 TISDALE AVE, CANTON, MS 39046-4965
(601) 859-6712
(601) 859-2355
Mailing address
5420 W PLANO PKWY, PLANO, TX 75093-4823
(972) 931-3800
(972) 767-6222
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
630
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220054
—
MS
Enumeration date
11/16/2005
Last updated
12/02/2014
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