Organization
A WARM HOME FOR DAD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RUTHA SMITH R.N. (OWNER/ADMINISTRATOR)
(601) 919-7040
Entity
Organization
Contact information
Practice address
1212 FOREST AVE, JACKSON, MS 39206-3219
(601) 919-7040
Mailing address
1771 HAMILTON BLVD, JACKSON, MS 39213-7807
(601) 919-7040
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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