Organization
PORT CITY ADULT DAYCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTIE JO PRUITT (OWNER)
(662) 701-5856
Entity
Organization
Contact information
Practice address
1255 S RACEWAY RD, GREENVILLE, MS 38703-8208
(662) 701-5856
(662) 796-0611
Mailing address
PO BOX 5453, GREENVILLE, MS 38704-5453
(662) 701-5856
(662) 796-0611
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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