Healthcare Provider Details

I. General information

NPI: 1346712023
Provider Name (Legal Business Name): FAITH AND HOPE ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 N STATE ST
JACKSON MS
39202-3006
US

IV. Provider business mailing address

737 N STATE ST
JACKSON MS
39202-3006
US

V. Phone/Fax

Practice location:
  • Phone: 601-807-5496
  • 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: NEAL ANGRUM
Title or Position: OWNER/CEO
Credential:
Phone: 601-807-5496