Organization · Type 2 NPI
Emmanuel Ridge of Dekalb Inc
Adult Day Care Clinic/Center · Dekalb, MS
NPI number
1992191084
Active
Practice location
14632 Hwy 39N/16E
Dekalb, MS 39328
Mailing address
PO Box 1522
Florence, MS 39073-1522
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse | 163WA2000X | R815521 (MS) |
| PACE Provider Organization | 251T00000X | 08752218 (MS) |
| In Home Supportive Care Agency | 253Z00000X | 03630719 (MS) |
| Adult Day Care Clinic/Center Primary | 261QA0600X | 08752218 (MS) |
Adult Day Care Clinic/Center: Definition to come...
About NPI 1992191084
Emmanuel Ridge of Dekalb Inc's National Provider Identifier is 1992191084, issued on Apr 15, 2015. The primary taxonomy on file is Adult Day Care Clinic/Center (261QA0600X), and the practice location is in Dekalb, MS. The record was last updated on Apr 15, 2015.