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 |