Organization
ANCOR ADULT DAY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERTRAND ANTOINE (PRESIDENT)
(662) 345-0222
Entity
Organization
Contact information
Practice address
813 HANCOCK STREET, TUTWILER, MS 38963
(662) 345-0222
Mailing address
PO BOX 1007, GREENWOOD, MS 38935-1007
(662) 345-0222
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
00437897
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00437897
—
MS
05
—
08081816
—
MS
Enumeration date
11/23/2007
Last updated
05/13/2008
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