Organization
JOSIAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACRYSTAL ZUKILYA WINDER (OWNER)
(662) 436-1030
Entity
Organization
Contact information
Practice address
404 THOMAS ST, GREENVILLE, MS 38703-6764
(662) 436-1030
Mailing address
119 CATHERINE ST, GREENVILLE, MS 38701-6206
(662) 436-1030
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
02/21/2021
Last updated
05/07/2024
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