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Organization
WILLOWOOD DEVELOPMENTAL CENTER
Active
Organization
WILLOWOOD DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CURTIS E. ALFORD (EXECUTIVE DIRECTOR)
(601) 366-0123
Entity
Organization
Contact information
Practice address
1635 BOLING ST, JACKSON, MS 39213-4418
(601) 366-0123
Mailing address
1635 BOLING ST, JACKSON, MS 39213-4418
(601) 366-0123
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770062
—
MS
05
—
09015618
—
MS
Enumeration date
01/23/2007
Last updated
01/27/2010
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