Provider Demographics
NPI:1104787258
Name:MID-DELTA ADULT DAY CARE LLC
Entity type:Organization
Organization Name:MID-DELTA ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-836-7421
Mailing Address - Street 1:502 N HAYDEN ST
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-3616
Mailing Address - Country:US
Mailing Address - Phone:662-247-3157
Mailing Address - Fax:662-247-3159
Practice Address - Street 1:502 N HAYDEN ST
Practice Address - Street 2:
Practice Address - City:BELZONI
Practice Address - State:MS
Practice Address - Zip Code:39038-3616
Practice Address - Country:US
Practice Address - Phone:662-247-3157
Practice Address - Fax:662-247-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care