Organization
GREEN ACRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA WILBERT MHA (CONSULTANT)
(601) 503-4432
Entity
Organization
Contact information
Practice address
1214 SHARON RD, CANTON, MS 39046-8814
(601) 503-4432
Mailing address
221 JACKS PL, BRANDON, MS 39047-4450
(602) 503-4432
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2013
Last updated
06/24/2013
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