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Organization
PROVIDENCE COMPANION CARE
Active
Organization
PROVIDENCE COMPANION CARE
Active
Other names
Providence Companion Care
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE FRAZER (PRESIDENT)
(662) 801-2040
Entity
Organization
Contact information
Practice address
317 HERITAGE DR STE 3B, OXFORD, MS 38655
(662) 234-0100
(662) 483-1801
Mailing address
PO BOX 2047, CLARKSDALE, MS 38614-8047
(662) 801-2040
(662) 483-1801
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/28/2018
Last updated
08/30/2018
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