NPI 1144577339

Tri-Vista Rehab, INC

Organisation Assisted Living Facility Tupelo, MS

Practice location

Address: 90a Clark Blvd, Tupelo, MS 38804-2801
Phone: (662) 840-0535
Fax: (662) 842-7915

Authorised official

Name: Kevin Troy Boutin
Title: President
Phone: (662) 840-0535

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence PT4554 (MS)

Other Assisted Living Facility providers in Mississippi →

Registry record

NPI: 1144577339
Entity type: Organization
NPI issued: 7 Aug 2012
Record last updated: 26 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.