OrganizationActive
Church Street Manor Assisted Living, Inc.
NPI 1780287979 · Assisted Living Facility · Ecru, MS
Provider details
- NPI number
- 1780287979
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Kenneth Long, President(662) 401-8930
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
36 Elm Ln
Ecru, MS 38841-9794
Phone: (662) 489-6462
Fax: (662) 489-6491
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 4150
Tupelo, MS 38803-4150
Registry dates
- Enumerated
- 2020-11-19
- Last updated
- 2020-11-19
- Certified
- 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.