Organization
SENIORS ON THE GO
Active
Other names
Lemoyne Place
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA SMITH (ADMINISTRATOR)
(228) 254-0370
Entity
Organization
Contact information
Practice address
14306 LEMOYNE BLVD, BILOXI, MS 39532-9760
(228) 396-1998
(228) 396-2907
Mailing address
4490 KENDALL CIR, GULFPORT, MS 39507-4000
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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