Organization
PLEASANT LIVING CARE COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKIA Y ROSA LSW (EXECUTIVE DIRECTOR)
(601) 966-1820
Entity
Organization
Contact information
Practice address
5185 SEDGWICK DR, JACKSON, MS 39211-4808
(601) 966-1820
(601) 206-1407
Mailing address
5185 SEDGWICK DR, JACKSON, MS 39211-4808
(601) 966-1820
(601) 206-1407
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
07828705
MS
376J00000X
Homemaker
Primary
07556060
MS
385H00000X
Respite Care
01682361
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01682361
—
MS
05
—
07556060
—
MS
05
—
07828705
—
MS
Enumeration date
03/01/2007
Last updated
02/19/2008
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