Organization
GOLDEN YEARS ADULT HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR ONEIL SMITH (OWNER/CEO/COO)
(601) 573-8651
Entity
Organization
Contact information
Practice address
121 COLONIAL GLN, JACKSON, MS 39211-3305
(601) 573-8651
Mailing address
121 COLONIAL GLN, JACKSON, MS 39211-3305
(601) 573-8651
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
—
MS
310400000X
Assisted Living Facility
—
MS
372600000X
Adult Companion
Primary
—
MS
Other
Enumeration date
11/01/2014
Last updated
11/01/2014
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