Organization
CIRCLE OF LIFE ADULT DAY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAQUANDA LATRICE BLAKE (OWNER/ DIRECTOR)
(662) 897-4594
Entity
Organization
Contact information
Practice address
210 GEROGE ST., GREENWOOD, MS 38930
(662) 644-5096
Mailing address
210 GEROGE ST., GREENWOOD, MS 38930
(662) 644-5096
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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