Odyssey Adult Day Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ODYSSEY ADULT DAY SERVICES

Practice address

1304 Clay St
Vicksburg, MS 39183-3012

Phone

(601) 831-1090

NPI assigned

Jul 20, 2011

Last updated

Jul 20, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Delynn Smith

Title

Operations Manager

Phone

(601) 831-1090

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1780972026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 CLAY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833012",
            "telephone_number": "601-831-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 CLAY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833012",
            "telephone_number": "601-831-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY ADULT DAY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DELYNN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "601-831-1090"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• On Call Nursing Agency (NA)

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.