Healthcare Provider Details

I. General information

NPI: 1295810901
Provider Name (Legal Business Name): HOLMES COUNTY LONG TERM CARE CENTER - DURANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15481 BOWLING GREEN RD
DURANT MS
39063-3565
US

IV. Provider business mailing address

15481 BOWLING GREEN RD
DURANT MS
39063-3565
US

V. Phone/Fax

Practice location:
  • Phone: 662-834-1321
  • Fax:
Mailing address:
  • Phone: 662-834-1321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number652
License Number StateMS

VIII. Authorized Official

Name: MR. WILLIAM L KENNEDY
Title or Position: DIRECTOR OF PATIENT FINANCIAL SERVI
Credential:
Phone: 601-984-4680