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General NPI Number Information
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NPI Number | 1184767568
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Entity Type | Organization
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Legal Business Name | COMMUNITY DEVELOPMENT INC.
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 N FRONT ST
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City | RICHTON
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State | MS
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Zip | 39476-2201
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Country | US
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Telephone | 601-788-5865
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Fax | 601-788-5722
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Provider Business Mailing Address
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Address Line | 200 N FRONT ST
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City | RICHTON
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State | MS
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Zip | 39476-2201
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Country | US
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Telephone | 601-788-5865
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Fax | 601-788-5722
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. OMA FAYE HIBBLER
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Credential |
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Telephone | 601-788-5865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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