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General NPI Number Information
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NPI Number | 1750725297
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Entity Type | Organization
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Legal Business Name | NEW COVENANT DAYCARE
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Dates
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Enumeration Date | 04/27/2013
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Last Update Date | 04/27/2013
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Provider Practice Location Address
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Address Line | 960 HIGHWAY 4 E
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City | HOLLY SPRINGS
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State | MS
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Zip | 38635-2145
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Country | US
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Telephone | 662-402-7735
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Fax |
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Provider Business Mailing Address
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Address Line | 460 MUSE RD
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City | HOLLY SPRINGS
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State | MS
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Zip | 38635-6903
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Country | US
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Telephone | 662-402-7735
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MISS THERESIA PHILLIPS
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Credential |
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Telephone | 662-402-7735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State | MS
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