Provider Demographics
NPI:1982304853
Name:HALL ADULT SENIOR DAYCARE LLC
Entity type:Organization
Organization Name:HALL ADULT SENIOR DAYCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-235-9690
Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-0402
Mailing Address - Country:US
Mailing Address - Phone:662-235-9690
Mailing Address - Fax:662-276-9763
Practice Address - Street 1:105 N HAYDEN ST
Practice Address - Street 2:
Practice Address - City:BELZONI
Practice Address - State:MS
Practice Address - Zip Code:39038-3931
Practice Address - Country:US
Practice Address - Phone:662-235-9690
Practice Address - Fax:662-276-9763
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HALL HEALTHCARE STAFFING SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service