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Organization

SILVER LIGHT ADULT DAYCARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHNNY EARL WILSON JR. (CHIEF EXECUTIVE OFFICER)
(769) 218-7005
Entity
Organization

Contact information

Practice address
142 CALLAWAY CIR, BYRAM, MS 39272-4499
(769) 218-7005
(601) 665-4430
Mailing address
142 CALLAWAY CIR, BYRAM, MS 39272-4499
(769) 218-7005
(601) 665-4430

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Enumeration date
01/03/2018
Last updated
01/03/2018
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