Organization
340 DESOTO AVENUE EXT OPERATIONS, LLC
Active
Other names
Greenbough Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LEHNER (MANAGHER)
(770) 698-9040
Entity
Organization
Contact information
Practice address
340 DESOTO AVENUE EXT, CLARKSDALE, MS 38614-2814
(253) 278-2258
(662) 627-5654
Mailing address
340 DESOTO AVENUE EXT, CLARKSDALE, MS 38614-2814
(253) 278-2258
(662) 627-5654
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000230119
—
MS
Enumeration date
03/04/2022
Last updated
09/13/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us