Organization
CANTON MS OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BATYA GORELICK (COO)
(201) 928-7800
Entity
Organization
Contact information
Practice address
1145 TISDALE AVE, CANTON, MS 39046-4965
(601) 859-6712
Mailing address
980 SYLVAN AVE, ENGLEWOOD CLIFFS, NJ 07632-3301
(201) 928-7800
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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