Healthcare Provider Details

I. General information

NPI: 1912041849
Provider Name (Legal Business Name): SOUTHERN COMMUNITY ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 IBERVILLE DR
OCEAN SPRINGS MS
39564-2919
US

IV. Provider business mailing address

1011 IBERVILLE DR
OCEAN SPRINGS MS
39564-2919
US

V. Phone/Fax

Practice location:
  • Phone: 228-875-5123
  • Fax: 888-304-0019
Mailing address:
  • Phone: 228-875-5123
  • Fax: 888-304-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SONYA LYNETTE RAMSEY
Title or Position: DIRECTOR OWNER
Credential: REGISTERED NURSE
Phone: 228-875-5123