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Organization
CREATIVE IMAGE PERSONAL CARE SERVICE LLC
Active
Organization
CREATIVE IMAGE PERSONAL CARE SERVICE LLC
Active
Other names
CREATIVE IMAGE RESPITE CARE SERVICE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANDRA RENA THOMAS (CEO/OWNER)
(662) 379-0238
Entity
Organization
Contact information
Practice address
503 HIGHWAY 82 E, INDIANOLA, MS 38751-2317
(662) 379-0238
(662) 887-8050
Mailing address
216 FRENCH RD, INDIANOLA, MS 38751-9668
(662) 379-0238
(662) 887-8050
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
311ZA0620X-ADULTCARE
—
385H00000X
Respite Care
Primary
385H00000X-RESPITE
MS
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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