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Organization
ST. JOHN'S RESPITE CARE SERVICES, LLC
Active
Organization
ST. JOHN'S RESPITE CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE BRADFORD JR. (MANAGING DIRECTOR)
(662) 647-1766
Entity
Organization
Contact information
Practice address
517 EAST STREET, INDIANOLA, MS 38751
(662) 647-1766
Mailing address
517 EAST STREET, INDIANOLA, MS 38751
(662) 647-1766
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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