Clc of Vaiden, LLC
NPI #1144210394 in Vaiden, Mississippi
Provider Information
- NPI Number
- 1144210394
- Entity Type
- Organization
- Organization Name
- Clc of Vaiden, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Oct 27, 2005
- Last Updated
- Jan 15, 2008
Practice Location
- Address
- 868 MULBERRY ST
- City
- Vaiden
- State
- Mississippi
- ZIP Code
- 39176-5385
- Phone
- (662) 464-7714
Authorized Official
- Name
- MR. DOUGLAS M. WRIGHT JR.
- Title
- MANAGING MEMBER
- Phone
- (662) 680-3148
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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