Organization
ANNIE J HEYMAN
Active
Other names
homeplace
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNIE JOYCE GILLENTINE-HEYMAN (OWNER)
(662) 963-0606
Entity
Organization
Contact information
Practice address
298 MAIN ST, NETTLETON, MS 38858-6012
(662) 963-0606
(662) 963-0606
Mailing address
298 MAIN ST, NETTLETON, MS 38858-6012
(662) 963-0606
(662) 963-0606
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
972
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
972
DH STATE LICENSE
MS
Enumeration date
11/28/2007
Last updated
06/24/2008
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