Indywood Glen, LLC
NPI #1225377534 in Greenwood, Mississippi
Provider Information
- NPI Number
- 1225377534
- Entity Type
- Organization
- Organization Name
- Indywood Glen, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Feb 6, 2013
- Last Updated
- Feb 6, 2013
Practice Location
- Address
- 1416 ERIE ST
- City
- Greenwood
- State
- Mississippi
- ZIP Code
- 38930-2103
- Phone
- (662) 455-3878
Authorized Official
- Name
- MRS. SHARON AYRES HARVEY
- Title
- ACTING MANAGER
- Phone
- (662) 455-3878
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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