| NPI | 1528503174 |
|---|---|
| Doing Business As | LIFE SOURCE HOME HEALTH |
| Entity Type | Organization |
| Authorized Contact | TONI H PARKINSON Authorized Representative 601-709-1408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: LA 1179) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-01-20 |