Healthcare Provider Details

I. General information

NPI: 1265768535
Provider Name (Legal Business Name): H & H ADULT DAYCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 RIVER RD
GREENWOOD MS
38930-4131
US

IV. Provider business mailing address

PO BOX 9393
GREENWOOD MS
38930-8993
US

V. Phone/Fax

Practice location:
  • Phone: 662-299-5025
  • Fax: 662-453-1818
Mailing address:
  • Phone: 662-299-5025
  • Fax: 662-453-1818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number5391106
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number26686
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number5060599
License Number StateMS

VIII. Authorized Official

Name: MRS. CAROLYN HEMPHILL
Title or Position: OWNER
Credential:
Phone: 662-299-5025