Diversicare of Tylertown, LLC
NPI #1083169072 in Tylertown, Mississippi
Provider Information
- NPI Number
- 1083169072
- Entity Type
- Organization
- Organization Name
- Diversicare of Tylertown, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DIVERSICARE LEASING COMPANY III, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Aug 18, 2016
- Last Updated
- Apr 7, 2023
Practice Location
- Address
- 200 MEDICAL CIR
- City
- Tylertown
- State
- Mississippi
- ZIP Code
- 39667-2069
- Phone
- (601) 876-2107
Authorized Official
- Name
- MATTHEW J WEISHAAR
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (615) 550-9459
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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