Provider Demographics
NPI:1770152225
Name:HODGES ADULT DAY CARE SERVICE INC
Entity type:Organization
Organization Name:HODGES ADULT DAY CARE SERVICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AALIYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-251-2729
Mailing Address - Street 1:741 HIGHWAY 245 S
Mailing Address - Street 2:
Mailing Address - City:OKOLONA
Mailing Address - State:MS
Mailing Address - Zip Code:38860-7945
Mailing Address - Country:US
Mailing Address - Phone:662-251-2729
Mailing Address - Fax:
Practice Address - Street 1:741 HIGHWAY 245 S
Practice Address - Street 2:
Practice Address - City:OKOLONA
Practice Address - State:MS
Practice Address - Zip Code:38860-7945
Practice Address - Country:US
Practice Address - Phone:662-251-2729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-20
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services