Organization
WAVERLY CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN B FOSTER (OWNER)
(662) 494-0074
Entity
Organization
Contact information
Practice address
315 W BROAD ST, WEST POINT, MS 39773-2805
(662) 494-0074
Mailing address
315 W BROAD ST, WEST POINT, MS 39773-2805
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
826
MS
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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