Basic Information
| Provider Information | |||||||||
| NPI: | 1427575505 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TREND HEALTH AND REHAB OF CARTHAGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 E FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390513603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012674551 | ||||||||
| FaxNumber: | 6012677242 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 E. FRANKLIN STREET | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 39051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012674551 | ||||||||
| FaxNumber: | 6012677242 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ELLIS | ||||||||
| AuthorizedOfficialFirstName: | TINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | COMPTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 6014990899 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 00023024 | 05 | MS | MEDICAID |