NPI 1750456034

Leake Extended Care Facility

Organisation Nursing Facility/Intermediate Care Facility Carthage, MS

Practice location

Address: 310 Ellis St, Carthage, MS 39051-3809
Phone: (601) 267-1100
Fax: (601) 267-1211

Authorised official

Name: Sandy Goolsby
Title: Accountant Business Office Manager
Phone: (601) 267-1100

Registered specialties

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 214 (MS)

Other Nursing Facility/Intermediate Care Facility providers in Mississippi →

Registry record

NPI: 1750456034
Entity type: Organization
NPI issued: 21 Nov 2006
Record last updated: 22 Aug 2020

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.