NPI 1932525714

Majestic Estates LLC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Forest, MS

Practice location

Address: 511 N Broad St, Forest, MS 39074-3511
Phone: (601) 405-2116
Mailing address: PO Box 1442, Forest, MS 39074-0442

Authorised official

Name: Pharen Nelson
Title: Owner
Phone: (601) 405-2116

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1932525714
Entity type: Organization
NPI issued: 17 Mar 2014
Record last updated: 17 Mar 2014

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.