Forever Youthful Adult Educational and Recreational Center
Organization Active NPI Adult Day Care Clinic/Center · Shaw, MS
NPI 1871936716 · NPPES record last updated Apr 10, 2013
Key facts
- NPI
- 1871936716
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- Legal business name
- FOREVER YOUTHFUL ADULT EDUCATIONAL AND RECREATIONAL CENTER
- Practice address
- 149 East Peeler Ave
Shaw, MS 38733-1053 - Phone
- (662) 754-3114
- Fax
- (662) 754-3055
- NPI assigned
- Apr 10, 2013
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mildred Taylor, R.N
- Title
- Administrator
- Phone
- (662) 754-3114
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | MS | Yes |
Addresses
Primary practice location
149 East Peeler Ave
Shaw, MS 38733-1053
Mailing address
149 East Peeler Avenue
PO Box 1053
Shaw, MS 38733-1053
Phone (662) 754-3114
Other names
- Forever Youthful
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All providers in Shaw, 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 Apr 10, 2013. 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.