OrganizationActive
Heavenly Palace Adult Center, Inc.
NPI 1790954592 · Preferred Provider Organization · Greenville, MS
Provider details
- NPI number
- 1790954592
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Authorized official
- Patrick Jackson, President
- License
- 07186736 (MS)
Mailing address
1654 Highway 1 N
Greenville, MS 38703-1943
Registry dates
- Enumerated
- 2008-02-26
- Last updated
- 2008-02-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.