Healthcare Provider Details

I. General information

NPI: 1982257853
Provider Name (Legal Business Name): TREND HEALTH & REHAB OF MERIDIAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 33RD ST
MERIDIAN MS
39305-3944
US

IV. Provider business mailing address

125 FOUNTAINS BLVD
MADISON MS
39110-6344
US

V. Phone/Fax

Practice location:
  • Phone: 601-499-0899
  • Fax: 601-499-0897
Mailing address:
  • Phone: 601-499-0899
  • Fax: 601-499-0897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHARLES BRUCE KELLY
Title or Position: MANAGING MEMBER
Credential:
Phone: 601-499-0899