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Organization

GRENADA NORTH DELTA HOSPICE & PALLIATIVE SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAYMOND E VALLIER (ADMINISTRATOR)
(662) 393-0170
Entity
Organization

Contact information

Practice address
141 N MAIN ST, DREW, MS 38737-3406
(662) 745-0587
(662) 745-0589
Mailing address
123 STATELINE RD E, SOUTHAVEN, MS 38671-1710
(662) 393-0170
(662) 393-0171

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
132
MS
251G00000X
Community Based Hospice Care Agency
137
MS

Other

Enumeration date
04/28/2010
Last updated
12/03/2013
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