Organization
LIGHT OF THE WORLD ADULT DAY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRY HUTCHINS (OWNER)
(662) 207-3744
Entity
Organization
Contact information
Practice address
405 W GRESHAM ST, INDIANOLA, MS 38751-2053
(662) 207-3744
Mailing address
405 W GRESHAM ST, INDIANOLA, MS 38751-2053
(662) 207-3744
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
111111111
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111111111
—
MS
Enumeration date
04/11/2014
Last updated
04/11/2014
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