Organization
WISH HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KEIMYEREIA RAILYNN LEWIS-JONES BA (OWNER)
(504) 518-6383
Entity
Organization
Contact information
Practice address
1520 29TH AVE STE 16, GULFPORT, MS 39501-2843
(228) 209-6307
(888) 725-7090
Mailing address
PO BOX 750423, NEW ORLEANS, LA 70175-0423
(228) 209-6307
(888) 725-7090
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/09/2018
Last updated
07/11/2019
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