Organization
COMPASSIONATE CARE PERSONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH L MYRICKS (CEO)
(769) 216-2587
Entity
Organization
Contact information
Practice address
330 EDGEWOOD TERRACE DR, STE B, JACKSON, MS 39206-6216
(769) 216-2587
Mailing address
330 EDGEWOOD TERRACE DR, STE B, JACKSON, MS 39206-6216
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07957011
—
MS
05
—
09603804
—
MS
Enumeration date
03/02/2016
Last updated
03/02/2016
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