Healthcare Provider Details

I. General information

NPI: 1689191629
Provider Name (Legal Business Name): BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S CHESTNUT ST
ABERDEEN MS
39730-3335
US

IV. Provider business mailing address

10996 FOUR SEASONS PL STE 100C
CROWN POINT IN
46307-7762
US

V. Phone/Fax

Practice location:
  • Phone: 219-395-0667
  • Fax:
Mailing address:
  • Phone: 219-228-1021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: DR. KIRNJOT SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 219-228-4355