Organization
MID SOUTH HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORA ANN SIMMONS (OWNER)
(601) 563-8092
Entity
Organization
Contact information
Practice address
234 W COURT ST, BROOKHAVEN, MS 39601-2750
(601) 563-8092
Mailing address
49 RED AUTUMN LN NE, BROOKHAVEN, MS 39601-6025
(601) 563-8092
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1719
MS
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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