Organization
EXCEPTIONAL LIVING HOME HEALTH CARE AGENCY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE BAILEY (CHIEF EXECUTIVE OFFICER)
(662) 947-3004
Entity
Organization
Contact information
Practice address
6385 CHESTERVILLE RD, TUPELO, MS 38801-8012
(662) 947-3004
Mailing address
270 TRACE COLONY PARK DR STE B, RIDGELAND, MS 39157-8810
(662) 947-3004
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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