Organization
AVA SENIORS ACADEMY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PEGGY CLAYBORNE (DIRECTOR)
(662) 299-7236
Entity
Organization
Contact information
Practice address
4795 MCWILLIE DR STE 120, JACKSON, MS 39206-5628
(769) 524-4191
(769) 524-4208
Mailing address
106 LUCKETT ST, GREENWOOD, MS 38930-3414
(662) 299-7236
(662) 455-7234
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
12/27/2019
Last updated
03/20/2023
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