Organization
TUNICA ADULT DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILLY J WILLIS (ASSISTANT ADMINISTRATOR)
(662) 363-2001
Entity
Organization
Contact information
Practice address
1530 EDWARDS AVE, TUNICA, MS 38676-9372
(662) 363-2001
Mailing address
PO BOX 2774, TUNICA, MS 38676-2774
(662) 363-2001
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
NONE REQUIRED
MS
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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