JERUSALEM OUTREACH CENTER INC NPI 1790237170

NPI Information

  • NPI: 1790237170
  • Provider Name: JERUSALEM OUTREACH CENTER, INC
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Doing Business As: JERUSALEM LIFE ADJUSTMENT CENTER
  • Address: 710 MARSHALL ST
    CHARLESTON, MS
    ZIP 38921
  • Phone: (662) 625-6788

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NPI Details

JERUSALEM OUTREACH CENTER, INC is an adult care home custodial care facility in Charleston, MS. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. JERUSALEM OUTREACH CENTER, INC NPI is 1790237170. The provider is registered as an organization entity type.
The provider Is Doing Business As Jerusalem Life Adjustment Center.

The provider's business location address is:

710 MARSHALL ST
CHARLESTON, MS
ZIP 38921-506
Phone: (662) 625-6788
Fax: (662) 625-6787

The provider's authorized official is Bessie L Brooks .
The authorized official title is Ceo/director and has the following contact phone number (662) 625-6788.

The enumeration date for this NPI number is 11/1/2016 and was last updated on 11/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1385HR2065XRespite CareRespite Care, Physical Disabilities, ChildNo
2311ZA0620XCustodial Care FacilityAdult Care HomeYes

What is NPI?

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This page was last updated on: 11/21/2025

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