Wisteria Gardens, LLC
NPI #1306031372 in Pearl, Mississippi
Provider Information
- NPI Number
- 1306031372
- Entity Type
- Organization
- Organization Name
- Wisteria Gardens, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Sep 12, 2007
- Last Updated
- Sep 12, 2007
Practice Location
- Address
- 5420 HIGHWAY 80 E
- City
- Pearl
- State
- Mississippi
- ZIP Code
- 39208-8924
- Phone
- (601) 988-6800
Authorized Official
- Name
- WILLIAM D HILL JR.
- Title
- ADMINISTRATOR
- Phone
- (601) 988-6800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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