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Pecan Grove

NPI 1205904604ActiveOrganization· Nursing Facility/Intermediate Care Facility· Ellisville, MS

Nursing Facility/Intermediate Care Facility in Ellisville, Mississippi, registered in NPPES in December 2006. The authorized official on file is Suzie Lassiter, Director Of Facility.

Overview

NPI1205904604
StatusActive
Entity typeOrganization
NPI issuedDec 1, 2006
Last updated in NPPESAug 22, 2020

Specialties and licenses

TaxonomyCodeLicenseState
Nursing Facility/Intermediate Care Facility Primary313M00000X284MS

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Nursing Facility/Intermediate Care Facility providers in Ellisville

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