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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