Organization Name: | SOUTHWEST DEVELOPMENT CORPORATION, INC. |
NPI Number: | 1275768319 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY T. IRVING (EXECUTIVE DIRECTOR/ADMINISTRATOR) |
Mailing Address: | 210 Gilchrist Street Post Office Box 699 Fayette |
State: | MS US |
Postal Code: | 390690699 |
Phone Number: | 6017863955 |
Fax Number: | 6017863910 |
NPI Enumeration Date: | 05/19/2009 |
NPI Last Update Date: | 06/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 09056303 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |