Organization
TALLAHATCHIE GENERAL HOSPITAL AND EXTENDED CARE FACILITY
Active
Other names
EXTENDED CARE FACILITY
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HOLEMAN GODSEY (REVENUE CYCLE DIRECTOR)
(662) 625-7191
Entity
Organization
Contact information
Practice address
141 DR T. T. LEWIS CIRCLE, CHARLESTON, MS 38921
(662) 647-5535
(662) 647-8432
Mailing address
PO BOX 230, CHARLESTON, MS 38921
(662) 647-5535
(662) 647-8432
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1054
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00023141
—
MS
Enumeration date
12/26/2007
Last updated
05/12/2025
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