Organization
ST. JOHN'S PERSONAL CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE BRADFORD, JR (MANAGING DIRECTOR)
(662) 647-1766
Entity
Organization
Contact information
Practice address
517 E BAKER ST, INDIANOLA, MS 38751-2503
(166) 264-7766
Mailing address
PO BOX 3, 409 STATE STREET, INDIANOLA, MS 38751-0000
(662) 647-1766
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/21/2015
Last updated
11/03/2016
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