Clc of Booneville, LLC
NPI #1447240122 in Booneville, Mississippi
Provider Information
- NPI Number
- 1447240122
- Entity Type
- Organization
- Organization Name
- Clc of Booneville, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Oct 25, 2005
- Last Updated
- Jan 28, 2008
Practice Location
- Address
- 200 LONG ST
- City
- Booneville
- State
- Mississippi
- ZIP Code
- 38829-4306
- Phone
- (662) 728-6234
Authorized Official
- Name
- MR. DOUGLAS M. WRIGHT JR.
- Title
- MANAGING MEMBER
- Phone
- (662) 680-3148
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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