25D2194108 CLIA NUMBER - SENTRY-NATCHEZ INC DBA MAGNOLIA VILLAGE

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Laboratory Demographics

CLIA Number: 25D2194108

Facility Name: SENTRY-NATCHEZ INC DBA MAGNOLIA VILLAGE

Facility Address:
311 HIGHLAND BLVD
NATCHEZ, MS
ZIP 39120
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Facility Phone Number: 601 446-5097

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1740604263

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	25D2194108
LAB Type	Assisted Living Facility
Facility Name	SENTRY-NATCHEZ INC DBA MAGNOLIA VILLAGE
Street	311 HIGHLAND BLVD
City	NATCHEZ
State	MS
ZIP	39120
Phone	601 446-5097
CertificateType	4
CertificateEffectiveDate	9/28/2022
CertificateExpirationDate	9/27/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024