Provider Demographics
NPI:1265614440
Name:YAZOO CITY REHABILITATION AND HEALTHCARE CENTER, LLC
Entity type:Organization
Organization Name:YAZOO CITY REHABILITATION AND HEALTHCARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & SECERTARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-626-0000
Mailing Address - Street 1:925 CALHOUN AVE
Mailing Address - Street 2:
Mailing Address - City:YAZOO CITY
Mailing Address - State:MS
Mailing Address - Zip Code:39194-3229
Mailing Address - Country:US
Mailing Address - Phone:662-746-7770
Mailing Address - Fax:662-746-4185
Practice Address - Street 1:925 CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:YAZOO CITY
Practice Address - State:MS
Practice Address - Zip Code:39194-3229
Practice Address - Country:US
Practice Address - Phone:662-746-7770
Practice Address - Fax:662-746-4185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARK MISSISSIPPI HOLDING COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-29
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00230074Medicaid
MS00230074Medicaid