| Organization Name: | JEFFERSON COUNTY NURSING HOME THERAPY |
| NPI Number: | 1356772594 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MONTINA RENA FLETCHER-LEWIS (ADMINISTRATOR) |
| Mailing Address: | 910 Main St Fayette |
| State: | MS US |
| Postal Code: | 39069 |
| Phone Number: | 6017863888 |
| Fax Number: | 6017869400 |
| NPI Enumeration Date: | 12/12/2013 |
| NPI Last Update Date: | 12/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283X00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Rehabilitation Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. |