NPI 1609131804

Broadmoor Adult Enrichment Daycare, INC.

Organisation Health Maintenance Organization Jackson, MS

Practice location

Address: 5176 Keele St, Jackson, MS 39206-4313
Phone: (601) 982-8156
Fax: (601) 982-8956

Authorised official

Name: Jennie Haynes Sturgis
Title: Administrator
Phone: (601) 982-8156

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

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Registry record

NPI: 1609131804
Entity type: Organization
NPI issued: 12 Jul 2012
Record last updated: 12 Jul 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.