Organization · Type 2 NPI
Church Street Manor Assisted Living, Inc.
Assisted Living Facility · Ecru, MS
NPI number
1780287979
Active
Practice location
36 Elm Ln
Ecru, MS 38841-9794
Fax (662) 489-6491
Mailing address
PO Box 4150
Tupelo, MS 38803-4150
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility Primary | 310400000X | None listed |
Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
About NPI 1780287979
Church Street Manor Assisted Living, Inc.'s National Provider Identifier is 1780287979, issued on Nov 19, 2020. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Ecru, MS. The record was last updated on Nov 19, 2020.