1205904604 PECAN GROVE
Nursing Facility/Intermediate Care Facility
Active
Basic Information
- Organization Name
- PECAN GROVE
- Enumeration Date
- December 1, 2006
- Last Update
- August 22, 2020
- Authorized Official
- SUZIE LASSITER
DIRECTOR OF FACILITY
Phone: (601) 477-9384
Practice Location
- Address
- 1101 HIGHWAY 11 S
ELLISVILLE, MS 394374443 - Phone
- (601) 477-9384
- Fax
- (601) 477-5700
Mailing Address
- Address
- 1101 HIGHWAY 11 S
ELLISVILLE, MS 394374443 - Phone
- (601) 477-9384
- Fax
- (601) 477-5700
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Nursing Facility/Intermediate Care Facility | 284 | MS | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00021847 | 05 | MS | N/A |
Frequently Asked Questions
What is PECAN GROVE's NPI number?
PECAN GROVE's NPI number is 1205904604.
Which doctor has NPI number 1205904604?
The doctor with NPI number 1205904604 is PECAN GROVE.
What is PECAN GROVE's practice address?
PECAN GROVE's practice address is 1101 HIGHWAY 11 S, ELLISVILLE, MS, 394374443.
Which doctor practices at 1101 HIGHWAY 11 S, ELLISVILLE, MS, 394374443?
PECAN GROVE practices at 1101 HIGHWAY 11 S, ELLISVILLE, MS, 394374443.
What is PECAN GROVE's phone number?
PECAN GROVE's phone number is (601) 477-9384.
Who is (601) 477-9384?
(601) 477-9384 is the phone number for PECAN GROVE.
What is PECAN GROVE's specialty?
PECAN GROVE's specialty is Nursing Facility/Intermediate Care Facility.
What type of doctor is PECAN GROVE?
PECAN GROVE is a Nursing Facility/Intermediate Care Facility.
Is PECAN GROVE a Nursing Facility/Intermediate Care Facility?
Yes, PECAN GROVE is a Nursing Facility/Intermediate Care Facility.
Is PECAN GROVE still practicing?
Yes, PECAN GROVE is currently practicing.
Is PECAN GROVE accepting new patients?
PECAN GROVE may be accepting new patients. Please call their office at (601) 477-9384 to inquire about availability.
Is NPI 1205904604 still active?
Yes, NPI 1205904604 is currently active.
Where does PECAN GROVE practice?
PECAN GROVE practices in ELLISVILLE, MS.