Beverly Forrest-Butts
Clinic/Center, Adult Day Care in Durant, MS. Individual provider (NPI-1).
NPI number1083171334
StatusActive
Last updated in NPPESFeb 22, 2019
Details
- NPI
- 1083171334
- Entity type
- Individual (NPI-1)
- Name
- Beverly Forrest-Butts
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 22, 2019
- Last updated
- Feb 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA0600X | Clinic/Center, Adult Day Care | 802066241 | MS | Yes |
Practice location
407 Nw Depot StDurant, MS 39063-3705
Phone 662-230-0947
Mailing address
510 Church StWinona, MS 38967-2802
Phone 662-230-0947
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