Organization Name: | GRANDCARE |
NPI Number: | 1104033224 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD O RESPESS (OWNER) |
Mailing Address: | 30627 Highway 8 E Grenada |
State: | MS US |
Postal Code: | 389017902 |
Phone Number: | 6628092727 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |