Individual
LANITA SHAVONN GRANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOMECARE PROVIDER
Contact information
Practice address
314 43RD AVE, MERIDIAN, MS 39307-6800
(601) 678-9239
(601) 453-5920
Mailing address
314 43RD AVE, MERIDIAN, MS 39307-6800
(601) 678-9239
(601) 830-1334
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
376J00000X
Homemaker
LCB20190000075
MS
Other
Enumeration date
02/28/2022
Last updated
02/08/2024
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