Provider Demographics
NPI:1992723696
Name:UNION COUNTY HEALTH & REHABILITATION CENTER, INC.
Entity type:Organization
Organization Name:UNION COUNTY HEALTH & REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-956-8276
Mailing Address - Street 1:1111 BRATTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-9416
Mailing Address - Country:US
Mailing Address - Phone:662-539-0502
Mailing Address - Fax:662-539-0602
Practice Address - Street 1:1111 BRATTON RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-9416
Practice Address - Country:US
Practice Address - Phone:662-539-0502
Practice Address - Fax:662-539-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS986314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04456547Medicaid
MS255312Medicare ID - Type Unspecified