Canton Ms Operating LLC
NPI #1922816818 in Canton, Mississippi
Provider Information
- NPI Number
- 1922816818
- Entity Type
- Organization
- Organization Name
- Canton Ms Operating LLC
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Dec 23, 2024
- Last Updated
- Dec 23, 2024
Practice Location
- Address
- 1145 TISDALE AVE
- City
- Canton
- State
- Mississippi
- ZIP Code
- 39046-4965
- Phone
- (601) 859-6712
Authorized Official
- Name
- MOISHE MAYER
- Title
- AUTHORIZED SIGNATORY
- Phone
- (718) 614-8341
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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