Organization
SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WIRT L PETERSON EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(601) 446-6044
Entity
Organization
Contact information
Practice address
1477 FE SELLERS HIGHWAY, MONTICELLO, MS 39654
(601) 587-0873
(601) 587-0936
Mailing address
100 S WALL ST, NATCHEZ, MS 39120-3477
(601) 446-6044
(601) 384-5200
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770117
—
MS
05
—
00770314
—
MS
Enumeration date
03/31/2008
Last updated
03/31/2008
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