Basic Information
| Provider Information | |||||||||
| NPI: | 1598139248 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TUNICA COUNTY HEALTH & REHAB, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13 NORTHTOWN DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392113047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019568276 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13 NORTHTOWN DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392113047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019568276 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2015 | ||||||||
| LastUpdateDate: | 11/18/2015 | ||||||||
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| AuthorizedOfficialLastName: | SHELTON | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6019568276 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.