Organization
JEFFERSON COUNTY DAY ACTIVITY & HEALTH SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKEISHA SHEPHERD (DIRECTOR)
(409) 365-4798
Entity
Organization
Contact information
Practice address
2349 9TH AVE, SUITE B, C, & D, PORT ARTHUR, TX 77642-3834
(409) 365-4798
Mailing address
2349 9TH AVE, SUITE B, C, & D, PORT ARTHUR, TX 77642-3834
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
311Z00000X
Custodial Care Facility
—
—
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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