Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Genesis and Light Center

Organization Voluntary or Charitable Agency · NPI 1457768814

Genesis and Light Center is a Voluntary or Charitable Agency in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2014.

Licensed in
MS
In the registry since
2014
Specialties on file
2

Practice location Address checks out

4914 N State St
Jackson, MS 39206-4046
Phone: (601) 362-6736
Fax: (601) 362-6737
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Day Care Clinic/Center (primary) Taxonomy 261QA0600X
Voluntary or Charitable Agency Taxonomy 251V00000X · Licence 25C4PAS-5598 (MS)

Record details

NPI number1457768814
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Albert Wilson — Executive Director · (601) 362-6736
NPI enumeratedJuly 17, 2014
Last updated in NPPESMarch 17, 2023
Certification dateMarch 17, 2023
Mailing address4914 N State St, Jackson, MS 39206-4046

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