Organization
NORTH STREET ADULT DAYCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSE MARY THOMAS (OWNER/DIRECTOR)
(662) 843-5758
Entity
Organization
Contact information
Practice address
222 NORTH STREET, CLEVELAND, MS 38732-2746
(662) 843-5758
(662) 843-5311
Mailing address
222 NORTH STREET, CLEVELAND, MS 38732-2746
(662) 843-5758
(662) 843-5311
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05779001
—
MS
Enumeration date
03/24/2008
Last updated
03/24/2008
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