Healthcare Provider Details

I. General information

NPI: 1114315918
Provider Name (Legal Business Name): PROMISE TO CARE ADULT DAYCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2014
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HIGHWAY 7 N
GREENWOOD MS
38930-3732
US

IV. Provider business mailing address

500 HIGHWAY 7 N
GREENWOOD MS
38930-3732
US

V. Phone/Fax

Practice location:
  • Phone: 662-299-7488
  • Fax:
Mailing address:
  • Phone:
  • 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. LINDA LOU WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 662-299-7488