# VICKSBURG HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245740190
- **Authorized official:** MS. TRACY CONVERSE (CEO)
- **Authorized official phone:** (269) 492-8423

## Contact information

- **Practice address:** 3075 E VW AVE, VICKSBURG, MI 49097-7739
- **Practice address phone:** (269) 492-8423
- **Practice address fax:** (866) 854-7795
- **Mailing address:** PO BOX 606, SCHOOLCRAFT, MI 49087-0606
- **Mailing address phone:** (269) 492-8423
- **Mailing address fax:** (866) 854-7795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/05/2017
- **Last updated:** 10/05/2017