Organization
ODYSSEY ADULT DAY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELYNN SMITH (OPERATIONS MANAGER)
(601) 831-1090
Entity
Organization
Contact information
Practice address
1304 CLAY ST, VICKSBURG, MS 39183-3012
(601) 831-1090
Mailing address
1304 CLAY ST, VICKSBURG, MS 39183-3012
(601) 831-1090
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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