Organization
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Active
Other names
Northeast Home Health Agency 2B
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE BOWMAN RN (DIRECTOR OF HOME HEALTH)
(601) 576-7853
Entity
Organization
Contact information
Practice address
517 CHURCH STREET, BOONEVILLE, MS 38829
(662) 728-5391
(662) 728-0132
Mailing address
517 CHURCH STREET, BOONEVILLE, MS 38829
(662) 728-5391
(662) 728-0132
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
9481
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00070500
—
MS
Enumeration date
12/14/2005
Last updated
06/08/2009
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