Healthcare Provider Details

I. General information

NPI: 1205823051
Provider Name (Legal Business Name): CARE CENTER OF ABERDEEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 JACKSON ST
ABERDEEN MS
39730-3349
US

IV. Provider business mailing address

505 JACKSON ST
ABERDEEN MS
39730-3349
US

V. Phone/Fax

Practice location:
  • Phone: 662-369-6431
  • Fax: 662-369-6473
Mailing address:
  • Phone: 662-369-6431
  • Fax: 662-369-6473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number561
License Number StateMS

VIII. Authorized Official

Name: CAROLYN SNUGGS
Title or Position: DIRECTOR OF QUAILTY ASSURANCE
Credential:
Phone: 205-979-0500