Clc of Jackson, LLC
NPI #1689664765 in Jackson, Mississippi
Provider Information
- NPI Number
- 1689664765
- Entity Type
- Organization
- Organization Name
- Clc of Jackson, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Oct 28, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1600 RAYMOND RD
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39204-4203
- Phone
- (601) 371-1700
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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