Organization
CAL-WAL SOUTHERN, LLC
Active
Other names
Springs of Life
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO CALVIN (OWNER/ADMINISTRATOR)
(601) 213-9783
Entity
Organization
Contact information
Practice address
114 W WALKER ST, GREENVILLE, MS 38701-4755
(601) 456-0447
Mailing address
2753 ASCOT PL, GREENVILLE, MS 38701-8304
(601) 456-0447
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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