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General NPI Number Information
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NPI Number | 1265955959
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Entity Type | Organization
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Legal Business Name | SENIOR EMPOWERMENT CENTER, LLC
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 2524 E ALEXANDER ST STE B
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City | GREENVILLE
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State | MS
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Zip | 38703-3330
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Country | US
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Telephone | 404-277-6032
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Fax |
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Provider Business Mailing Address
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Address Line | 2524 E ALEXANDER ST
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City | GREENVILLE
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State | MS
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Zip | 38703-3330
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Country | US
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Telephone | 404-277-6032
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. BELINDA DORSEY FLETCHER
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Credential | PMHT
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Telephone | 404-277-6032
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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 | MS
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