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General NPI Number Information
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NPI Number | 1073217014
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Entity Type | Organization
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Legal Business Name | BRIGHTER DAYS ADULT DAY CARE LLC
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 309 AIRPORT RD S STE B
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City | PEARL
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State | MS
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Zip | 39208-6678
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Country | US
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Telephone | 769-234-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 107 VICTORIA LN
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City | CLINTON
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State | MS
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Zip | 39056-4031
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KEVIN WOODSON JR.
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Credential | REGISTERED NURSE
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Telephone | 769-234-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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