Healthcare Provider Details

I. General information

NPI: 1073546230
Provider Name (Legal Business Name): FOREST HILL NURSING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 COOPER RD
JACKSON MS
39212-4023
US

IV. Provider business mailing address

927 COOPER RD
JACKSON MS
39212-4023
US

V. Phone/Fax

Practice location:
  • Phone: 601-372-0141
  • Fax: 601-372-0931
Mailing address:
  • Phone: 601-372-0141
  • Fax: 601-372-0931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MIMS RAY JONES
Title or Position: ADMINISTRATOR
Credential:
Phone: 601-372-0141