| NPI | 1750725297 |
|---|---|
| Doing Business As | ADULT RECREATION CENTER |
| Entity Type | Organization |
| Authorized Contact | THERESIA PHILLIPS Owner/CEO 662-402-7735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2013-04-27 |