Organization
NISSI LLC
Active
Other names
Magnolia Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AARON HINES LPN (NURSE MANAGER)
(601) 469-4389
Entity
Organization
Contact information
Practice address
410 E FIRST ST, FOREST, MS 39074-4204
(601) 469-4389
(601) 469-4377
Mailing address
410 E FIRST ST, FOREST, MS 39074-4204
(601) 469-4389
(601) 469-4377
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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