Organization
FONDREN COVE RELAY, INC.
Active
Other names
Fondren Cove Assited Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CAMMIE E KITCHENS (EXECUTIVE DIRECTOR)
(601) 981-3945
Entity
Organization
Contact information
Practice address
4520 N STATE ST, JACKSON, MS 39206-5307
(601) 981-3945
Mailing address
PO BOX 55861, JACKSON, MS 39296-5861
(601) 981-3945
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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