Organization
KIDS' KASTLE GLUCKSTADT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JETUWAN M BROWN (MANAGING OFFICER)
(601) 278-6710
Entity
Organization
Contact information
Practice address
112 WESTFALEN DRIVE, CANTON, MS 39046
(601) 499-0167
(601) 499-0294
Mailing address
115 AULENBROCK DR STE A, CANTON, MS 39046-7036
(601) 499-0167
(601) 499-0294
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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