Healthcare Provider Details

I. General information

NPI: 1720991581
Provider Name (Legal Business Name): SHIELDING HEARTS CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 GREGORY ST
GREENVILLE MS
38701-7619
US

IV. Provider business mailing address

28 ABIDE DR
GREENVILLE MS
38701-8158
US

V. Phone/Fax

Practice location:
  • Phone: 662-347-6672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: KASHIELD GHOLSTON
Title or Position: OWNER
Credential:
Phone: 662-347-6672