OrganizationActive
Countrywood Manor Assisted Living, Inc.
NPI 1104429398 · Assisted Living Facility · Mantachie, MS
Provider details
- NPI number
- 1104429398
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Authorized official
- Kenneth Long, President
Practice location
145 Watson Dr
Mantachie, MS 38855-8381
Phone: (662) 282-7808
Fax: (662) 282-7738
Mailing address
Po Box 4150
Tupelo, MS 38803-4150
Registry dates
- Enumerated
- 2020-11-19
- Last updated
- 2020-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.