Community Care Center of Vicksburg LLC
NPI #1225086374 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1225086374
- Entity Type
- Organization
- Organization Name
- Community Care Center of Vicksburg LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 4, 2006
- Last Updated
- Apr 30, 2013
Practice Location
- Address
- 3103 WISCONSIN AVE
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-4825
- Phone
- (601) 638-1514
Authorized Official
- Name
- MRS. TONI PARKINSON
- Title
- ADMIN. ASST.
- Phone
- (601) 709-1408
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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