| NPI | 1750746616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRAYQ MCWILLIAMS Owner 601-342-6103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: FL 276267) |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2015-12-20 |
| Last Update Date | 2015-12-20 |