Provider Demographics
NPI:1003132937
Name:PARENTAL ADULT DAYCARE
Entity Type:Organization
Organization Name:PARENTAL ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRESSA
Authorized Official - Middle Name:I
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-375-2875
Mailing Address - Street 1:409 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:TUTWILER
Mailing Address - State:MS
Mailing Address - Zip Code:38963
Mailing Address - Country:US
Mailing Address - Phone:662-375-2875
Mailing Address - Fax:662-345-0038
Practice Address - Street 1:409 WEST STREET
Practice Address - Street 2:
Practice Address - City:TUTWILER
Practice Address - State:MS
Practice Address - Zip Code:38963
Practice Address - Country:US
Practice Address - Phone:662-375-2875
Practice Address - Fax:662-345-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care