Healthcare Provider Details

I. General information

NPI: 1598749210
Provider Name (Legal Business Name): HINDS COUNTY NURSING &REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 ALBERMARLE ROAD
JACKSON MS
39213
US

IV. Provider business mailing address

3454 ALBERMARLE ROAD
JACKSON MS
39213
US

V. Phone/Fax

Practice location:
  • Phone: 601-362-5394
  • Fax: 601-366-9276
Mailing address:
  • Phone: 601-362-5394
  • Fax: 601-366-9276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number375
License Number StateMS

VIII. Authorized Official

Name: MRS. TINA L ELLIS
Title or Position: COMPTROLLER
Credential:
Phone: 601-304-0980