Organization
PROFESSIONAL HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M SANDRIDGE (OWNER)
(901) 834-0118
Entity
Organization
Contact information
Practice address
355 S SANGA RD, CORDOVA, TN 38018-4813
(901) 834-0118
Mailing address
6783 TERRY CHASE, OLIVE BRANCH, MS 38654-1448
(901) 834-0118
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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