Organization
BLUE CARE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA LUCKETT FNP (OWNER)
(662) 253-8543
Entity
Organization
Contact information
Practice address
204 STATELINE RD W, SOUTHAVEN, MS 38671-1608
(662) 253-8543
Mailing address
PO BOX 1593, SOUTHAVEN, MS 38671-0017
(662) 253-8543
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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