Organization

Emmanuel Ridge of Dekalb

Debarred entity

United States. Named in 1 sanctions listing.

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Sanctions and listings1

  • Effective
    24 Aug 2018

    Official designation

    Mississippi Division of MedicaidUS Mississippi Medicaid Terminated Provider ListUnited States

    Noncompliance with Provider Agreement

    medicaid.ms.gov

Identifiers1

IdentifierNumber
NPI number1992191084

Addresses1

  • 14632 HWY 39N/16E

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