Organization
PATRIOT HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAYTORIA MARQUITA-KADESHIA WILKINS (OWNER)
(601) 896-1644
Entity
Organization
Contact information
Practice address
324 MANGUM AVE, MENDENHALL, MS 39114-3015
(601) 675-7100
(601) 675-7007
Mailing address
324 MANGUM AVE, MENDENHALL, MS 39114-3015
(601) 675-7100
(601) 675-7007
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/04/2014
Last updated
01/13/2016
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