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Organization

PROVIDENCE HEALTHCARE OF MS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICH MANN R.N. (DIRECTOR/MANAGER)
(601) 720-5460
Entity
Organization

Contact information

Practice address
6735 I-55 SOUTH FRONTAGE ROAD, SUITE 2-A, BYRAM, MS 39272
(601) 720-5460
(601) 878-0687
Mailing address
PO BOX 502, TERRY, MS 39170-0502
(601) 720-5460
(601) 878-0687

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
R866849
MS

Other

Enumeration date
05/08/2013
Last updated
08/27/2015
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