Provider Demographics
NPI:1043562804
Name:WE CARE ADULT DAY CARE CENTE4R
Entity Type:Organization
Organization Name:WE CARE ADULT DAY CARE CENTE4R
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-299-9446
Mailing Address - Street 1:123 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-2605
Mailing Address - Country:US
Mailing Address - Phone:662-299-9446
Mailing Address - Fax:662-453-1065
Practice Address - Street 1:1709 CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-5817
Practice Address - Country:US
Practice Address - Phone:662-299-9446
Practice Address - Fax:662-453-1065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care