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Organization

AT HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NARSHUNDA ROGERS (COO)
(601) 807-8222
Entity
Organization

Contact information

Practice address
1004 COLLEGE ST, PORT GIBSON, MS 39150-2434
(601) 437-3524
(601) 437-3524
Mailing address
1004 COLLEGE ST, PORT GIBSON, MS 39150-2434
(601) 437-3524
(601) 437-3524

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
00770583
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00770583
MS
Enumeration date
07/19/2011
Last updated
07/19/2011
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