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Organization
FULL POTENTIAL LLC
Active
Organization
FULL POTENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMEKIA RENIX JACKSON (ADMINISTRATOR)
(662) 563-0690
Entity
Organization
Contact information
Practice address
405 HIGHWAY 51 S, BATESVILLE, MS 38606-2549
(662) 563-0690
(662) 563-7304
Mailing address
405 HIGHWAY 51 S, BATESVILLE, MS 38606-2549
(662) 563-0690
(662) 563-7304
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/12/2018
Last updated
06/11/2020
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