Southwest Development Corporation, Inc.
Organization Active NPI Respite Care · Fayette, MS
NPI 1275768319 · NPPES record last updated Jun 9, 2009
Key facts
- NPI
- 1275768319
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Respite Care 385H00000X
- License
- 09056303 (MS)
- Legal business name
- SOUTHWEST DEVELOPMENT CORPORATION, INC.
- Practice address
- 210 Gilchrist Street
Post Office Box 699
Fayette, MS 39069-0699 - Phone
- (601) 786-3955
- Fax
- (601) 786-3910
- NPI assigned
- May 19, 2009
- Organization subpart
- No
Authorized official
- Name
- Ms. Mary T. Irving
- Title
- Executive Director/Administrator
- Phone
- (601) 786-3955
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Medgar Evers Hospice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | 09056303 | MS | Yes |
Addresses
Primary practice location
210 Gilchrist Street
Post Office Box 699
Fayette, MS 39069-0699
Mailing address
210 Gilchrist Street
Post Office Box 699
Fayette, MS 39069-0699
Phone (601) 786-3955
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0770119 | Medicaid | MS |
Other names
- Medgar Evers Respite Care
Other providers in Fayette, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2009. 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.