National Provider Identifier Database

CANTON MS OPCO LLC
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

CANTON MS OPCO LLC
1145 TISDALE AVE
CANTON, MS39046-4965
Phone: 601-859-6712
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for CANTON MS OPCO LLC

NPI Number 1881336352
Legal business name
LBN
CANTON MS OPCO LLC
Authorized official BATYA GORELICK - (COO)
Entity Organization
Organization subpart No
Enumeration date 04/13/2022
Last updated 04/13/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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