Individual
ALTAMESE WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 PARKER CV, BYHALIA, MS 38611-8415
(901) 647-4314
Mailing address
74 PARKER CV, BYHALIA, MS 38611-8415
(901) 647-4314
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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