Provider Demographics
NPI:1306307053
Name:MAJESTY ADULT DAYCARE SERVICES LLC
Entity type:Organization
Organization Name:MAJESTY ADULT DAYCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-627-6129
Mailing Address - Street 1:PO BOX 2028
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75710-2028
Mailing Address - Country:US
Mailing Address - Phone:903-617-6120
Mailing Address - Fax:903-617-6115
Practice Address - Street 1:900 W BOW ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-5133
Practice Address - Country:US
Practice Address - Phone:903-617-6120
Practice Address - Fax:903-617-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care