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General NPI Number Information
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NPI Number | 1699201178
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Entity Type | Organization
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Legal Business Name | SELECT CHOICE ADULT DAY CARE, LLC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 223 BEAVER DAM RD
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City | TUTWILER
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State | MS
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Zip | 38963-5229
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Country | US
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Telephone | 662-641-6835
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Fax | 662-843-2096
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Provider Business Mailing Address
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Address Line | 1201 NORTH ST
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City | CLEVELAND
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State | MS
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Zip | 38732-2815
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Country | US
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Telephone | 662-641-6835
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Fax | 662-843-2096
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA J HENRY
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Credential |
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Telephone | 662-641-6835
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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 | MS
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