OrganizationActive
340 Desoto Avenue Ext Operations, LLC
NPI 1932856531 · Skilled Nursing Facility · Clarksdale, MS
Provider details
- NPI number
- 1932856531
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Authorized official
- Tim Lehner, Managher
Practice location
340 Desoto Avenue Ext
Clarksdale, MS 38614-2814
Phone: (253) 278-2258
Fax: (662) 627-5654
Mailing address
340 Desoto Avenue Ext
Clarksdale, MS 38614-2814
Registry dates
- Enumerated
- 2022-03-04
- Last updated
- 2024-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.