Organization
GREENVILLE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MURRY REAGOR (SOLE OWNER)
(662) 334-4646
Entity
Organization
Contact information
Practice address
1880 FAIRGROUND ROAD, GREENVILLE, MS 38703
(662) 334-4646
(662) 334-4691
Mailing address
1880 FAIRGROUND ROAD, GREENVILLE, MS 38703
(662) 334-4646
(662) 334-4691
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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