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Organization
MID SOUTH SENIOR CARE, LLC
Active
Organization
MID SOUTH SENIOR CARE, LLC
Active
Other names
Mid-South Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CHAD GILLILAND (PRESIDENT)
(901) 766-7660
Entity
Organization
Contact information
Practice address
5050 POPLAR AVE, SUITE 2400, MEMPHIS, TN 38157-0101
(901) 766-7660
(901) 328-1353
Mailing address
5050 POPLAR AVE, SUITE 2400, MEMPHIS, TN 38157-0101
(901) 766-7660
(901) 328-1353
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
L000000013736
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445514
—
TN
Enumeration date
11/07/2014
Last updated
11/07/2014
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