Provider Demographics
NPI:1639325038
Name:CALHOUN HEALTH SERVICES
Entity Type:Organization
Organization Name:CALHOUN HEALTH SERVICES
Other - Org Name:CALHOUN HEALTH SERVICES NURSING HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FISCAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SUBER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:662-628-6611
Mailing Address - Street 1:140 BURKE CALHOUN CITY RD
Mailing Address - Street 2:
Mailing Address - City:CALHOUN CITY
Mailing Address - State:MS
Mailing Address - Zip Code:38916-9690
Mailing Address - Country:US
Mailing Address - Phone:662-628-6611
Mailing Address - Fax:662-628-6300
Practice Address - Street 1:140 BURKE CALHOUN CITY RD
Practice Address - Street 2:
Practice Address - City:CALHOUN CITY
Practice Address - State:MS
Practice Address - Zip Code:38916-9690
Practice Address - Country:US
Practice Address - Phone:662-628-6611
Practice Address - Fax:662-628-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS299313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility