Organization
CHANGING LIFE AT HOME MS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANDERSON (ADMINISTRATOR)
(662) 929-2808
Entity
Organization
Contact information
Practice address
3709 JORDAN VIEW DR, SOUTHAVEN, MS 38671-7077
(662) 929-2808
Mailing address
3709 JORDAN VIEW DR, SOUTHAVEN, MS 38671-7077
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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