Organization
NORTH GROVE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS AUDREY WILEY (ADMINISTRATOR)
(601) 922-2008
Entity
Organization
Contact information
Practice address
641 N FLAG CHAPEL RD, JACKSON, MS 39209-2204
(601) 922-2008
(601) 922-2817
Mailing address
641 N FLAG CHAPEL RD, JACKSON, MS 39209-2204
(601) 922-2008
(601) 922-2817
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
697
MS
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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