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Organization

VITACARE HEALTH & FAMILY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JALEESA JACKSON (OWNER)
(601) 730-0295
Entity
Organization

Contact information

Practice address
3531 HWY 24, GLOSTER, MS 39638
(601) 730-0295
Mailing address
PO BOX 751, CENTREVILLE, MS 39631-0751

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
251E00000X
Home Health Agency
Primary
251G00000X
Community Based Hospice Care Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
310400000X
Assisted Living Facility
3104A0625X
Assisted Living Facility (Mental Illness)
320700000X
Physical Disabilities Residential Treatment Facility
343800000X
Secured Medical Transport (VAN)
343900000X
Non-emergency Medical Transport (VAN)
385H00000X
Respite Care

Other

Enumeration date
03/05/2025
Last updated
03/05/2025
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