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General NPI Number Information
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NPI Number | 1043103849
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Entity Type | Organization
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Legal Business Name | REACH ADULT RECREATION SERVICE, LLC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 153 E GHOLSON AVE
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City | HOLLY SPRINGS
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State | MS
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Zip | 38635-3016
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Country | US
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Telephone | 662-274-3049
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Fax | 662-274-3081
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Provider Business Mailing Address
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Address Line | 153 E GHOLSON AVE
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City | HOLLY SPRINGS
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State | MS
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Zip | 38635-3016
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Country | US
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Telephone | 662-274-3049
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Fax | 662-274-3081
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Authorized Official
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Title or Position | C.E.O
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Name | MRS. JOYCE SMITH BOWENS
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Credential | L.P.N
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Telephone | 662-274-3049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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