Willow Creek Retirement Center

LBN: Wcrl, Llc
Willow Creek Retirement Center is an health care organization with primary practice located at 49 Willow Creek Ln , Jackson MS 39272-9255. 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. Wcrl, Llc can be contacted via phone (601) 863-4201, or through Rotolo, David via phone (601) 853-2667.

Contact Information

Primary practice address
49 Willow Creek Ln Jackson MS 39272-9255
Phone: (601) 863-4201
Fax: (601) 863-4202
Website:
Map and Directions
Authorized official contact:
Name: Rotolo, David
Phone: (601) 853-2667

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 926 Mississippi

Profile Details

NPI number 1780758904
LBN Legal business name Wcrl, Llc
DBA Doing business as Willow Creek Retirement Center
Authorized official Rotolo, David
Entity Organization
Organization subpart 1 No
Enumeration date Nov 20th, 2006
Last updated Feb 20th, 2008 - about 17 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 1780758904 NPPES
Mississippi MEDICAID 00230143

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