Heavenly Palace Adult Center, Inc.

LBN: Heavenly Palace Adult Center, Inc.
Heavenly Palace Adult Center, Inc. is an health care organization with primary practice located at 1654 Highway 1 N , Greenville MS 38701-0000. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Heavenly Palace Adult Center, Inc. can be contacted via phone (662) 378-7262, or through Jackson, Patrick via phone (662) 378-7262.

Contact Information

Primary practice address
1654 Highway 1 N Greenville MS 38701-0000
Phone: (662) 378-7262
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Patrick
Phone: (662) 378-7262

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X 07186736 Mississippi

Profile Details

NPI number 1790954592
LBN Legal business name Heavenly Palace Adult Center, Inc.
DBA Doing business as
Authorized official Jackson, Patrick
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2008
Last updated Feb 26th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790954592 NPPES
Mississippi MEDICAID 07186736

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