Organization
WISDOM ADULT DAY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMETRIA M PARKS (ADMINISTRATOR)
(662) 545-4904
Entity
Organization
Contact information
Practice address
162 T M JONES HWY, BOYLE, MS 38730-2005
(662) 545-4904
(662) 545-4902
Mailing address
162 T M JONES HWY, BOYLE, MS 38730-2005
(662) 545-4904
(662) 545-4902
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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