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Organization

HEAVEN SENT FOOT HEALTHCARE, PLCC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEALICE NIKITA YOUNG RN (RN/CEO)
(662) 670-4197
Entity
Organization

Contact information

Practice address
160 CYPRESS STREET, TCHULA, MS 39169
(662) 670-4197
Mailing address
PO BOX 572, TCHULA, MS 39169-0572
(662) 670-4197

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
894906
MS
251J00000X
Nursing Care Agency
894906
MS

Other

Enumeration date
05/24/2018
Last updated
05/24/2018
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