Healthcare Provider Details

I. General information

NPI: 1225476906
Provider Name (Legal Business Name): GOLDEN BLESSINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N FILLMORE ST
CORINTH MS
38834-4823
US

IV. Provider business mailing address

516 N FILLMORE ST
CORINTH MS
38834-4823
US

V. Phone/Fax

Practice location:
  • Phone: 601-953-2994
  • Fax:
Mailing address:
  • Phone: 601-953-2994
  • 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: MR. NICK R BAIN
Title or Position: OWNER/MANAGER
Credential:
Phone: 601-953-2994