Organization
EMMANUEL RIDGE HOME CARE AGENCY INC
Active
Other names
Emmanuel Ridge In-Home Respite Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEATRICE A EZEM RN, CM, CLNC (PRESIDENT/CEO)
(601) 927-9839
Entity
Organization
Contact information
Practice address
2073 HIGHWAY 49 S, FLORENCE, MS 39073-9422
(601) 709-3304
(601) 709-3307
Mailing address
2073 HWY 49 SOUTH, FLORENCE, MS 39073-1944
(601) 709-3304
(601) 709-3307
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
07123515
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07123515
—
MS
Enumeration date
01/03/2008
Last updated
01/03/2008
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