NPI 1497007207

Tunica Adult Day Care

Organisation Exclusive Provider Organization Tunica, MS

Practice location

Address: 1530 Edwards Ave, Tunica, MS 38676-9372
Phone: (662) 363-2001
Mailing address: PO Box 2774, Tunica, MS 38676-2774

Authorised official

Name: Billy J Willis
Title: Assistant Administrator
Phone: (662) 363-2001

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence NONE REQUIRED (MS)

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Registry record

NPI: 1497007207
Entity type: Organization
NPI issued: 4 Oct 2012
Record last updated: 4 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.