Provider Demographics
NPI:1003409665
Name:SME I - IUKA, LLC
Entity Type:Organization
Organization Name:SME I - IUKA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-929-7536
Mailing Address - Street 1:1308 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852-7423
Mailing Address - Country:US
Mailing Address - Phone:662-424-0023
Mailing Address - Fax:
Practice Address - Street 1:1308 N PEARL ST
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-7423
Practice Address - Country:US
Practice Address - Phone:662-424-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility