NPI 1720284839 · live from the CMS NPI Registry
Autumn View Senior Day Services, LLC
Physical Medicine & Rehabilitation in Gulfport, MS. National Provider Identifier 1720284839, active.
NPI record
| NPI | 1720284839 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Medicine & Rehabilitation 208100000X |
| Practice location | 14321 Dedeaux Rd, Suite 14, Gulfport, MS 39503 |
| Practice phone | 228-831-0048 |
| Enumerated | June 25, 2007 |
| Last updated | July 17, 2007 |
| Authorized official | Kwantrell Green, Ceo Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Day Training, Developmentally Disabled Services | 251C00000X | — |
| Home Health | 251E00000X | — |
| Hospice Care, Community Based | 251G00000X | — |
| Physical Medicine & Rehabilitation primary | 208100000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.