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Organization
PAVILION PERSONAL CARE LLC
Active
Organization
PAVILION PERSONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DAVID KLUEMPKE (CHIEF MANAGER)
(612) 940-5934
Entity
Organization
Contact information
Practice address
1450B BEACH BLVD, BILOXI, MS 39530
(612) 940-5934
Mailing address
PO BOX 8056, BILOXI, MS 39535-8056
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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