Organization
THE OLIVER HOUSE ADULT DAYCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERROLYNN EDWARDS REGISTERED NURSE (ADMINISTRATOR)
(601) 695-1701
Entity
Organization
Contact information
Practice address
2008 HIGHWAY 51, WESSON, MS 39191-9502
(601) 643-1533
(601) 643-1534
Mailing address
204 POPLAR ST, BROOKHAVEN, MS 39601-2839
(601) 695-1701
(601) 833-4774
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
172A00000X
MS
311ZA0620X
Adult Care Home Facility
Primary
251QA0600X
MS
311ZA0620X
Adult Care Home Facility
376J00000X
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01330234
—
MS
05
—
03037821
—
MS
05
—
04387341
—
MS
Enumeration date
12/31/2007
Last updated
12/31/2007
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