Desoto Pediatric Extended Care LLC
NPI #1538526140 in Southhaven, Mississippi
Provider Information
- NPI Number
- 1538526140
- Entity Type
- Organization
- Organization Name
- Desoto Pediatric Extended Care LLC
- Primary Specialty
- Skilled Nursing Facility - Nursing Care, Pediatric
- Enumeration Date
- Jan 27, 2016
- Last Updated
- Jan 27, 2016
Practice Location
- Address
- 750 STATELINE ROAD EAST
- City
- Southhaven
- State
- Mississippi
- ZIP Code
- 38671
- Phone
- (662) 468-1320
Authorized Official
- Name
- MAUREEN GALLAGHER
- Title
- OWNER
- Phone
- (318) 512-9218
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility - Nursing Care, Pediatric — Nursing Care, Pediatric |
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