Healthcare Provider Details
I. General information
NPI: 1619206463
Provider Name (Legal Business Name): CROWN HEALTH & REHAB OF NATCHEZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2009
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
344 ARLINGTON AVE
NATCHEZ MS
39120-3551
US
IV. Provider business mailing address
344 ARLINGTON AVE
NATCHEZ MS
39120-3551
US
V. Phone/Fax
- Phone: 601-443-2344
- Fax: 601-443-9862
- Phone: 601-443-2344
- Fax: 601-443-9862
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
J
MURPHY
Title or Position: VICE PRESIDENT
Credential:
Phone: 901-937-7994