Organization
Screen this subjectEmmanuel Ridge of Dekalb
Debarred entityUnited States. Named in 1 sanctions listing.
Sanctions and listings1
- Effective
- 24 Aug 2018
Official designation
Mississippi Division of MedicaidUS Mississippi Medicaid Terminated Provider ListUnited States
Noncompliance with Provider Agreement
Identifiers1
| Identifier | Number |
|---|---|
| NPI number | 1992191084 |
Addresses1
14632 HWY 39N/16E
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