THE OLIVER HOUSE ADULT DAYCARE
Adult Care Home
Wesson, Mississippi
Provider NPI: 1659556371
Organization Information:Organization Name: THE OLIVER HOUSE ADULT DAYCARE
Practice Location:
2008 HIGHWAY 51 WESSON, MS 39191 US
Tel: 601-643-1533 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2008 HIGHWAY 51 WESSON, MS 39191 US
Tel: 601-643-1533 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | MS | 172A00000X |
N | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility | MS | 376J00000X |
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility | MS | 251QA0600X |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
01330234 | MS | 05 | |
04387341 | MS | 05 | |
03037821 | MS | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin