Organization
ALEXANDER, VINCENT & ALEXANDRIA LLC
Active
Other names
Alexander, Vincent & Alexandria Personal Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY LOUISE CLAYBORNE (CEO)
(662) 299-7236
Entity
Organization
Contact information
Practice address
219 FORD AVE, JACKSON, MS 39209-3322
(662) 299-7236
(769) 524-4208
Mailing address
4795 MCWILLIE DR, JACKSON, MS 39206-5628
(769) 524-4191
(769) 524-4208
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
09603294
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09603294
—
MS
Enumeration date
03/10/2017
Last updated
03/10/2017
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