Willie Mae Clerk Adult Day Care ,LLC
Organization Active NPI Adult Day Care Clinic/Center · Boyle, MS
NPI 1124405840 · NPPES record last updated May 1, 2015
Key facts
- NPI
- 1124405840
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- License
- 08133227 (MS)
- Legal business name
- WILLIE MAE CLERK ADULT DAY CARE ,LLC
- Practice address
- 151 Gaines Hwy
Boyle, MS 38730-9512 - Phone
- (662) 846-7732
- Fax
- (662) 846-7732
- NPI assigned
- May 1, 2015
- Organization subpart
- No
Authorized official
- Name
- Miss Josephine Clerk, RN
- Title
- Executive Director
- Phone
- (662) 846-7732
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 08133227 | MS | Yes |
Addresses
Primary practice location
151 Gaines Hwy
Boyle, MS 38730-9512
Mailing address
PO Box 155
Boyle, MS 38730-0155
Phone (662) 846-7732
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08133227 | Medicaid | MS |
Other providers in Boyle, MS
- Yolanda H. Jackson
- North Sunflower Medical Center
- Dana Pannell
- Patrick Brent Smith
- Glynn Nora Standifer
- Wisdom Adult Day Center
All providers in Boyle, MS · Adult Day Care Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.