Organization
HOLISTIC GERIATRIC CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY S STEWART CNP (CEO)
(601) 527-7585
Entity
Organization
Contact information
Practice address
10026 LIZELIA RD, MERIDIAN, MS 39305-9595
(601) 527-7585
Mailing address
10026 LIZELIA RD, MERIDIAN, MS 39305-9595
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04689005
—
MS
Enumeration date
08/12/2013
Last updated
08/12/2013
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