Organization
GRACE & MERCY PERSONAL CARE PROVIDER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLEAN DENISE PITTMAN (PRESIDENT/OWNER)
(662) 262-3194
Entity
Organization
Contact information
Practice address
63 GWENN RAY DR, EUPORA, MS 39744-3403
(662) 258-1018
Mailing address
24224 MS HIGHWAY 15, MATHISTON, MS 39752-6876
(662) 263-3194
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/28/2022
Last updated
04/10/2023
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