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Organization
BEDFORD ALZHEIMERS CARE CENTER, LLC
Active
Organization
BEDFORD ALZHEIMERS CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK A BEVON, III (ADMINISTRATOR)
(601) 582-9157
Entity
Organization
Contact information
Practice address
300 CAHAL ST, SUITE B, HATTIESBURG, MS 39401-2922
(601) 582-9157
(601) 582-2639
Mailing address
300 CAHAL ST, HATTIESBURG, MS 39401-2922
(601) 582-9157
(601) 582-2639
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
1008
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00232558
—
MS
Enumeration date
11/28/2007
Last updated
11/28/2007
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