| NPI | 1144713413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEKIA RENIX JACKSON Administrator 662-563-0690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 251S00000X Community/Behavioral Health | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2020-06-11 |