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General NPI Number Information
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NPI Number | 1710200480
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Entity Type | Organization
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Legal Business Name | GHC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 700 E SUNFLOWER RD
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City | CLEVELAND
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State | MS
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Zip | 38732-2726
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Country | US
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Telephone | 662-843-0030
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Fax | 662-846-0833
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Provider Business Mailing Address
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Address Line | PO BOX 1888
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City | CLEVELAND
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State | MS
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Zip | 38732-1888
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Country | US
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Telephone | 662-843-0030
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Fax | 662-846-0833
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHARLINE BRANDON
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Credential |
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Telephone | 662-843-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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