Healthcare Provider Details

I. General information

NPI: 1932774379
Provider Name (Legal Business Name): GRACE FOR TODAY ADULT LIFE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 12/30/2023
Certification Date: 12/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 HIGHWAY 51 S
BATESVILLE MS
38606-2552
US

IV. Provider business mailing address

519 WOODLAND RD
BATESVILLE MS
38606-7331
US

V. Phone/Fax

Practice location:
  • Phone: 662-267-9673
  • Fax: 662-712-6266
Mailing address:
  • Phone: 662-267-9673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENISE P CORBETT
Title or Position: OWNER
Credential:
Phone: 662-267-9673