Organization
FOREVER YOUTHFUL ADULT EDUCATIONAL AND RECREATIONAL CENTER
Active
Organization
FOREVER YOUTHFUL ADULT EDUCATIONAL AND RECREATIONAL CENTER
Active
Other names
Forever Youthful
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILDRED TAYLOR R.N (ADMINISTRATOR)
(662) 754-3114
Entity
Organization
Contact information
Practice address
149 EAST PEELER AVE, SHAW, MS 38733-1053
(662) 754-3114
(662) 754-3055
Mailing address
149 EAST PEELER AVENUE, PO BOX 1053, SHAW, MS 38733-1053
(662) 754-3114
(662) 754-3055
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
MS
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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