NPI 1326197211

Cottage Grove Nursing Home, LP

Organisation Skilled Nursing Facility Jackson, MS

Practice location

Address: 1116 Forest Ave, Jackson, MS 39206-3216
Phone: (601) 366-6461
Fax: (601) 362-4041

Authorised official

Name: Juadine B Cleveland
Title: Administrator
Phone: (601) 366-6461

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 326 (MS)

Other Skilled Nursing Facility providers in Mississippi →

Registry record

NPI: 1326197211
Entity type: Organization
NPI issued: 9 Jan 2007
Record last updated: 26 Mar 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.