Organization
NORTH DELTA STAFFING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND E VALLIER (CEO/ADMINISTRATOR)
(662) 393-0170
Entity
Organization
Contact information
Practice address
520 GOODMAN RD E, SOUTHAVEN, MS 38671-9526
(662) 393-0170
(662) 393-0171
Mailing address
520 GOODMAN RD E, SOUTHAVEN, MS 38671-9526
(662) 393-0170
(662) 393-0171
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02005311
—
MS
05
—
07236817
—
MS
Enumeration date
07/21/2016
Last updated
07/21/2016
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