| NPI | 1053746487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADREA SMITH Owner 601-818-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-05 |