Organization
SOUTHWEST DEVELOPMENT CORPORATION, INC.
Active
Other names
Medgar Evers Respite Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY T. IRVING (EXECUTIVE DIRECTOR/ADMINISTRATOR)
(601) 786-3955
Entity
Organization
Contact information
Practice address
210 GILCHRIST STREET, POST OFFICE BOX 699, FAYETTE, MS 39069-0699
(601) 786-3955
(601) 786-3910
Mailing address
210 GILCHRIST STREET, POST OFFICE BOX 699, FAYETTE, MS 39069-0699
(601) 786-3955
(601) 786-3910
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
09056303
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0770119
—
MS
Enumeration date
05/19/2009
Last updated
06/09/2009
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