# TUNICA ADULT DAY CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497007207
- **Authorized official:** MR. BILLY J WILLIS (ASSISTANT ADMINISTRATOR)
- **Authorized official phone:** (662) 363-2001

## Contact information

- **Practice address:** 1530 EDWARDS AVE, TUNICA, MS 38676-9372
- **Practice address phone:** (662) 363-2001
- **Mailing address:** PO BOX 2774, TUNICA, MS 38676-2774
- **Mailing address phone:** (662) 363-2001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | NONE REQUIRED | MS | Yes |

## Other

- **Enumeration date:** 10/04/2012
- **Last updated:** 10/04/2012