Organization
GRACEY & MURPHY FAITHFUL CODE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANERIVA ANN LEE (CASE MANGER)
(601) 809-8684
Entity
Organization
Contact information
Practice address
1058 RIDGEWOOD PL, SUITE G, JACKSON, MS 39211-2002
(601) 809-9222
Mailing address
1058 RIDGEWOOD PL, SUITE G, JACKSON, MS 39211-2002
(601) 809-9222
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
326285
MS
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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