Healthcare Provider Details

I. General information

NPI: 1508701426
Provider Name (Legal Business Name): AT HOME ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CHURCH ST
PORT GIBSON MS
39150-2108
US

IV. Provider business mailing address

306 CHURCH ST
PORT GIBSON MS
39150-2108
US

V. Phone/Fax

Practice location:
  • Phone: 601-255-1690
  • Fax: 601-255-1692
Mailing address:
  • Phone: 601-437-3524
  • Fax: 601-437-3570

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. DOROTHY FELTON
Title or Position: CEO
Credential:
Phone: 601-415-5921