Healthcare Provider Details

I. General information

NPI: 1346378387
Provider Name (Legal Business Name): CARE CENTER OF CLINTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 PINEHAVEN RD
CLINTON MS
39056-3455
US

IV. Provider business mailing address

1251 PINEHAVEN RD
CLINTON MS
39056-3455
US

V. Phone/Fax

Practice location:
  • Phone: 601-924-2996
  • Fax: 601-924-6447
Mailing address:
  • Phone: 601-924-2996
  • Fax: 601-924-6447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number486
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number486
License Number StateMS

VIII. Authorized Official

Name: MS. MARDIE O DIXON
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 601-924-2996