Cottage Grove Nursing Home, Lp

LBN: Cottage Grove Nursing Home, Lp
Cottage Grove Nursing Home, Lp is an health care organization with primary practice located at 1116 Forest Ave , Jackson MS 39206-3216. 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. Cottage Grove Nursing Home, Lp can be contacted via phone (601) 366-6461, or through Cleveland, Juadine B via phone (601) 366-6461.

Contact Information

Primary practice address
1116 Forest Ave Jackson MS 39206-3216
Phone: (601) 366-6461
Fax: (601) 362-4041
Website:
Map and Directions
Authorized official contact:
Name: Cleveland, Juadine B
Phone: (601) 366-6461

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 326 Mississippi

Profile Details

NPI number 1326197211
LBN Legal business name Cottage Grove Nursing Home, Lp
DBA Doing business as
Authorized official Cleveland, Juadine B
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2007
Last updated Mar 26th, 2013 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1326197211 NPPES
Mississippi MEDICAID 00023040

Popular Providers