NPI 1205175908

William McCallister

Organisation Skilled Nursing Facility Jackson, MS

Practice location

Address: 1600 Raymond Rd, Jackson, MS 39204-4203
Phone: (601) 371-1700
Mailing address: 704 Forest Ave, Jackson, MS 39206-3308

Authorised official

Name: William Charles McCallister
Title: Lpn
Phone: (769) 572-5002

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence P326102 (MS)

Other Skilled Nursing Facility providers in Mississippi →

Registry record

NPI: 1205175908
Entity type: Organization
NPI issued: 31 Jan 2013
Record last updated: 31 Jan 2013

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.