Provider Demographics
NPI:1649781253
Name:GREATER HEARTS ADULT DAYCARE
Entity type:Organization
Organization Name:GREATER HEARTS ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-452-5204
Mailing Address - Street 1:PO BOX 2107
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-1807
Mailing Address - Country:US
Mailing Address - Phone:662-452-5204
Mailing Address - Fax:662-452-5021
Practice Address - Street 1:124 CURTIS STREET
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751
Practice Address - Country:US
Practice Address - Phone:662-452-5204
Practice Address - Fax:662-452-5021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care