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General NPI Number Information
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NPI Number | 1104787258
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Entity Type | Organization
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Legal Business Name | MID-DELTA ADULT DAY CARE LLC
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 502 N HAYDEN ST
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City | BELZONI
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State | MS
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Zip | 39038-3616
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Country | US
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Telephone | 662-247-3157
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Fax | 662-247-3159
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Provider Business Mailing Address
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Address Line | 502 N HAYDEN ST
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City | BELZONI
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State | MS
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Zip | 39038-3616
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Country | US
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Telephone | 662-247-3157
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Fax | 662-247-3159
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Authorized Official
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Title or Position | OWNER
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Name | CLARA REED
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Credential |
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Telephone | 662-836-7421
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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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