Organization
SUNSET RESIDENTIAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA JEAN SHOULDERS PRESIDENT (OWNER)
(601) 831-2371
Entity
Organization
Contact information
Practice address
20114B HIGHWAY 18, HERMANVILLE, MS 39086-9747
(601) 535-2059
(601) 535-2059
Mailing address
20114B HIGHWAY 18, HERMANVILLE, MS 39086-9747
(601) 535-2059
(601) 535-2059
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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