Provider Demographics
NPI:1295955185
Name:R & N ADULT DAYCARE & YOUTH CENTER
Entity type:Organization
Organization Name:R & N ADULT DAYCARE & YOUTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-827-5755
Mailing Address - Street 1:108 EAST SOUTH ST.
Mailing Address - Street 2:P.O. BOX 351
Mailing Address - City:HOLLANDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38748-3240
Mailing Address - Country:US
Mailing Address - Phone:662-827-5755
Mailing Address - Fax:662-827-5766
Practice Address - Street 1:108 E. SOUTH ST.
Practice Address - Street 2:200 MERCER AVE.
Practice Address - City:HOLLANDALE
Practice Address - State:MS
Practice Address - Zip Code:38748-3240
Practice Address - Country:US
Practice Address - Phone:662-827-5755
Practice Address - Fax:662-827-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services