Organization
MID-SOUTH HOME HEALTH AGENCY, LLC
Active
Other names
CENTERWELL HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(334) 684-3919
Entity
Organization
Contact information
Practice address
1204 W MAGNOLIA AVE, GENEVA, AL 36340-1610
(334) 684-3919
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51512791
G2
—
01
—
51512793
G2
—
01
—
51512795
G2
—
01
—
51512797
G2
—
05
—
HOM7048A
—
AL
Enumeration date
07/03/2006
Last updated
09/02/2022
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