Organization
MID-SOUTH HOME HEALTH AGENCY, LLC
Active
Other names
CENTERWELL HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(334) 347-0234
Entity
Organization
Contact information
Practice address
1239 RUCKER BLVD, ENTERPRISE, AL 36330-3624
(334) 347-0234
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51512775
G2
—
01
—
51512778
G2
—
01
—
51512779
G2
—
05
—
HOM7013A
—
AL
Enumeration date
07/02/2006
Last updated
09/02/2022
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