Organization
ELITE PROFESSIONAL HOMECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JHAMIGKHA WILLIAMS (CNA/OWNER)
(601) 357-0773
Entity
Organization
Contact information
Practice address
405 BRIARWOOD DR STE 205B2, JACKSON, MS 39206-3052
(601) 745-0127
Mailing address
705 OAK ST, NEWTON, MS 39345-3038
(601) 745-0127
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1269950
NON MEDICAL
MS
Enumeration date
08/23/2021
Last updated
02/08/2024
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