Organization
JERUSALEM OUTREACH CENTER, INC
Active
Other names
Jerusalem Life Adjustment Center
Organization subpart
No
Provider details
NPI number
Authorized official
BESSIE L BROOKS (CEO/DIRECTOR)
(662) 625-6788
Entity
Organization
Contact information
Practice address
710 MARSHALL ST, CHARLESTON, MS 38921-9506
(662) 625-6788
(662) 625-6787
Mailing address
710 MARSHALL ST, P.O. BOX 405, CHARLESTON, MS 38921-9506
(662) 625-6788
(662) 625-6787
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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