Organization
EMMANUEL RECREATIONAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA JEAN BRYANT (OWNER)
(662) 723-0034
Entity
Organization
Contact information
Practice address
101 BIZZELL ST, PACE, MS 38764-0162
(662) 723-0034
(662) 723-0034
Mailing address
PO BOX 162, 101 BIZZELL ST, PACE, MS 38764-0162
(662) 723-0034
(662) 723-0034
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1071260
MS
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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