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General NPI Number Information
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NPI Number | 1063725331
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Entity Type | Organization
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Legal Business Name | CARRINGTON HOUSE
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 1670 WHITEHOUSE RD
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City | IUKA
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State | MS
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Zip | 38852-9013
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Country | US
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Telephone | 662-424-2186
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Fax | 662-423-3308
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Provider Business Mailing Address
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Address Line | 1670 WHITEHOUSE RD
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City | IUKA
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State | MS
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Zip | 38852-9013
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Country | US
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Telephone | 662-424-2186
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Fax | 662-423-3398
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Authorized Official
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Title or Position | OENER
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Name | MS. BEVERLY ANN CUMMINGS
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Credential | LPN
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Telephone | 662-424-2186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 05351056
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License Number State | MS
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