Canton Manor

LBN: Preferred Care Developmental Centers Of Ms I Inc
Canton Manor is an health care organization with primary practice located at 1145 Tisdale Ave , Canton MS 39046-4965. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Preferred Care Developmental Centers Of Ms I Inc can be contacted via phone (601) 859-6712, or through Collier, Jamie Latture via phone (972) 931-3800.

Contact Information

Primary practice address
1145 Tisdale Ave Canton MS 39046-4965
Phone: (601) 859-6712
Fax: (601) 859-2355
Website:
Map and Directions
Authorized official contact:
Name: Collier, Jamie Latture
Phone: (972) 931-3800

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 630 Mississippi

Profile Details

NPI number 1659353688
LBN Legal business name Preferred Care Developmental Centers Of Ms I Inc
DBA Doing business as Canton Manor
Authorized official Collier, Jamie Latture
Entity Organization
Organization subpart 1 No
Enumeration date Nov 16th, 2005
Last updated Dec 2nd, 2014 - about 10 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 1659353688 NPPES
Mississippi MEDICAID 00220054

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