Organization
BROADWAY MANOR LIMITED LIABILITY
Active
Other names
Broadway Manor Residential CareHome
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JMELBA H THOMPSON (DIRECTOR)
(662) 702-5007
Entity
Organization
Contact information
Practice address
446 N BROADWAY STREET, GREENVILLE, MS 38701-2552
(662) 702-5007
Mailing address
515 N BROADWAY ST, GREENVILLE, MS 38701-2552
(662) 702-5007
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1096
MS
Other
Enumeration date
05/11/2015
Last updated
07/24/2015
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