Organization
NORTHSIDE HAVEN ASSOCIATION, INC.
Active
Other names
Miss Bernice's House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZELPHA MONTGOMERY WHATLEY (EXECUTIVE DIRECTOR)
(662) 834-3344
Entity
Organization
Contact information
Practice address
50 PATTON PLACE RD, LEXINGTON, MS 39095-5851
(662) 834-3344
(662) 834-3314
Mailing address
50 PATTON PLACE RD, LEXINGTON, MS 39095-5851
(662) 834-3344
(662) 834-3314
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
992
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09350005
—
MS
Enumeration date
03/26/2007
Last updated
12/11/2007
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