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Organization
SOUTHWEST DEVELOPMENT CORPORATION, INC.
Active
Organization
SOUTHWEST DEVELOPMENT CORPORATION, INC.
Active
Other names
Medgar Evers Respite Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY T. IRVING (EXECUTIVE DIRECTOR/ADMINISTRATOR)
(601) 786-3955
Entity
Organization
Contact information
Practice address
210 GILCHRIST STREET, POST OFFICE BOX 699, FAYETTE, MS 39069-0699
(601) 786-3955
(601) 786-3910
Mailing address
210 GILCHRIST STREET, POST OFFICE BOX 699, FAYETTE, MS 39069-0699
(601) 786-3955
(601) 786-3910
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
09056303
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0770119
—
MS
Enumeration date
05/19/2009
Last updated
06/09/2009
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