Organization
EBENEZER HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY HIBBLER (ADMINISTRATOR/CEO)
(662) 541-5009
Entity
Organization
Contact information
Practice address
1189 MAIN ST, TUNICIA, MS 38676
(662) 363-0102
(662) 363-0103
Mailing address
1189 MAIN ST, TUNICIA, MS 38676
(662) 541-5009
(662) 363-0103
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07988034
—
MS
Enumeration date
09/03/2008
Last updated
09/22/2008
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