Organization
AT HOME ADULT DAY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY JEANETTE FELTON REGISTERED NURSE (CEO)
(601) 415-5921
Entity
Organization
Contact information
Practice address
115 E MAIN ST, GLOSTER, MS 39638-9006
(769) 325-2004
(601) 225-4787
Mailing address
306 CHURCH ST, PORT GIBSON, MS 39150-2108
(601) 415-5921
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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