Organization
ICONIC HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA EASTERLING (MANAGER)
(888) 506-5336
Entity
Organization
Contact information
Practice address
270 HOSEY MIKELL RD, BASSFIELD, MS 39421
(888) 506-5336
(662) 593-0502
Mailing address
PO BOX 728, BASSFIELD, MS 39421-0728
(888) 506-5336
(662) 593-0502
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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