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Organization
CARE COMPANION AT HOME LLC
Active
Organization
CARE COMPANION AT HOME LLC
Active
Other names
Care Companion At Home LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KENLEY PAYNE (CO-OWNER)
(601) 549-2135
Entity
Organization
Contact information
Practice address
225 GENERAL ROBERT E BLOUNT DRIVE, BASSFIELD, MS 39421
(601) 606-0784
Mailing address
16B HEARTWOOD PL, HATTIESBURG, MS 39402-9088
(601) 549-2135
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
NULL
164W00000X
Licensed Practical Nurse
—
—
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
385H00000X
Respite Care
—
NULL
385HR2055X
Child Mental Illness Respite Care
—
NULL
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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