| NPI | 1790237170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BESSIE L BROOKS CEO/Director 662-625-6788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 385HR2065X Respite Care Respite Care, Physical Disabilities, Child |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |