Organization
PERSONAL CARE SERVICES MIDSOUTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER L BLACK MBA (EXECUTIVE DIRECTOR)
(901) 313-9238
Entity
Organization
Contact information
Practice address
1723 HIGHWAY 51 S STE E, COVINGTON, TN 38019-3628
(901) 313-9238
(901) 313-9236
Mailing address
201 W LIBERTY AVE, STE. 105, COVINGTON, TN 38019-2500
(901) 313-9238
(901) 313-9236
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1000000008567
TN
Other
Enumeration date
05/06/2011
Last updated
08/22/2023
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