Shady Lawn, LLC
NPI #1184613143 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1184613143
- Entity Type
- Organization
- Organization Name
- Shady Lawn, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- VANGUARD HEALTHCARE, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Oct 20, 2005
- Last Updated
- May 24, 2018
Practice Location
- Address
- 60 SHADY LAWN PL
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180
- Phone
- (601) 636-1448
Authorized Official
- Name
- MR. WILLIAM D. ORAND
- Title
- CEO
- Phone
- (615) 250-7100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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