Providence Pcc of Grenada, LLC
NPI #1477869881 in Grenada, Mississippi
Provider Information
- NPI Number
- 1477869881
- Entity Type
- Organization
- Organization Name
- Providence Pcc of Grenada, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Aug 23, 2010
- Last Updated
- Aug 23, 2010
Practice Location
- Address
- 1855 HILL DR
- City
- Grenada
- State
- Mississippi
- ZIP Code
- 38901-5003
- Phone
- (662) 226-8556
Authorized Official
- Name
- MRS. DEBBIE P MITCHELL
- Title
- EXECUTIVE DIRECTOR
- Phone
- (662) 226-8556
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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