Healthcare Provider Details

I. General information

NPI: 1588513741
Provider Name (Legal Business Name): HOL FAMILY LIFE ADC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W 4TH ST
HATTIESBURG MS
39401-4753
US

IV. Provider business mailing address

2000 W 4TH ST
HATTIESBURG MS
39401-4753
US

V. Phone/Fax

Practice location:
  • Phone: 601-466-7102
  • Fax:
Mailing address:
  • Phone: 601-466-7102
  • 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: DEBORAH WILLIAMS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 601-466-7102