Organization
CANTON MS OPERATING LLC
Active
Other names
Madison Court
Organization subpart
No
Provider details
NPI number
Authorized official
MOISHE MAYER (AUTHORIZED SIGNATORY)
(718) 614-8341
Entity
Organization
Contact information
Practice address
1145 TISDALE AVE, CANTON, MS 39046-4965
(601) 859-6712
Mailing address
710 OBRECHT RD, SYKESVILLE, MD 21784-7650
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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