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Organization
SOUTHERN GRACE HOME CARE
Active
Organization
SOUTHERN GRACE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOMEKA LOTT (CEO)
(601) 447-1106
Entity
Organization
Contact information
Practice address
12 AMUR LN, HATTIESBURG, MS 39402-5510
(601) 447-1106
Mailing address
12 AMUR LN, HATTIESBURG, MS 39402-5510
(601) 447-1106
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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