Indywood LLC
NPI #1205908670 in Indianola, Mississippi
Provider Information
- NPI Number
- 1205908670
- Entity Type
- Organization
- Organization Name
- Indywood LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Nov 14, 2006
- Last Updated
- Sep 16, 2009
Practice Location
- Address
- 541 DORSETT DR
- City
- Indianola
- State
- Mississippi
- ZIP Code
- 38751-2386
- Phone
- (662) 887-3005
Authorized Official
- Name
- MS. ELETA J GRIMMETT
- Title
- OWNER
- Phone
- (662) 534-2387
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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