Organization
MICAH'S WALK FOR AUTISM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTE TASHAY FORD MCBRIDE LPN, B.S.H.A. (FOUNDER/PRESIDENT/CEO)
(662) 263-6044
Entity
Organization
Contact information
Practice address
424 SHADOWOOD DR, RIDGELAND, MS 39157-4155
(662) 263-6044
Mailing address
424 SHADOWOOD DR, RIDGELAND, MS 39157-4155
(662) 263-6044
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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