Organization
JEANS NON MEDICAL CARE RESPITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OZIE D PHIPPS RESPITE PROVIDER (CEO)
(662) 382-8883
Entity
Organization
Contact information
Practice address
612 BROAD STREET, 612, SLEDGE, MS 38270
(662) 382-8883
(662) 382-7776
Mailing address
430 WILLIAMS AVE, P. O. BOX 72, SLEDGE, MS 38670
(662) 382-8883
(662) 382-7776
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07354332
—
MS
Enumeration date
10/06/2006
Last updated
12/13/2007
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