Provider Demographics
NPI:1982080388
Name:GOLDEN ANGELS ADULT DAYCARE, LLC
Entity Type:Organization
Organization Name:GOLDEN ANGELS ADULT DAYCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:601-394-3941
Mailing Address - Street 1:199 MARY MAGDALENE RD
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-8435
Mailing Address - Country:US
Mailing Address - Phone:601-394-3941
Mailing Address - Fax:601-928-5399
Practice Address - Street 1:199 MARY MAGDALENE RD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-8435
Practice Address - Country:US
Practice Address - Phone:601-394-3941
Practice Address - Fax:601-928-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health