- Enrollment id
- O20260220002583
- Enrollment state
- MS
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1255405205
- Multiple npi flag
- N
- Ccn
- 255113
- Associate id
- 1052892783
- Organization name
- MISSISSIPPI COMMCARE CORPORATION A NONPROFIT CORPORATION
- Doing business as name
- FIRST HORIZON BANK
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- RULEVILLE COMMUNITY CARE CENTER
- Affiliation entity name
- COMMCARE CORPORATION
- Affiliation entity id
- 150
- Address line 1
- 800 STANSEL DR
- City
- RULEVILLE
- State
- MS
- Zip code
- 387713320