Provider Demographics
NPI:1073990917
Name:NORTH MISSISSIPPI ADULT DAY CARE SERVICES LLC
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI ADULT DAY CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OZELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-622-0180
Mailing Address - Street 1:714 E SERVICE DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MS
Mailing Address - Zip Code:38618-3881
Mailing Address - Country:US
Mailing Address - Phone:662-622-0180
Mailing Address - Fax:662-622-0189
Practice Address - Street 1:714 E SERVICE DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MS
Practice Address - Zip Code:38618-3881
Practice Address - Country:US
Practice Address - Phone:662-622-0180
Practice Address - Fax:662-622-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care