Tishomingo Community Living Center

LBN: Clc Of Iuka, Llc
Tishomingo Community Living Center is an health care organization with primary practice located at 1410 W Quitman St , Iuka MS 38852-1129. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Clc Of Iuka, Llc can be contacted via phone (662) 423-3422, or through Wright, Douglas M. via phone (662) 680-3148.

Contact Information

Primary practice address
1410 W Quitman St Iuka MS 38852-1129
Phone: (662) 423-3422
Fax: (662) 423-5259
Website:
Map and Directions
Authorized official contact:
Name: Wright, Douglas M.
Phone: (662) 680-3148

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 643 Mississippi

Profile Details

NPI number 1457341976
LBN Legal business name Clc Of Iuka, Llc
DBA Doing business as Tishomingo Community Living Center
Authorized official Wright, Douglas M.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2005
Last updated Jan 28th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457341976 NPPES
Mississippi MEDICAID 0230179

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