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Organization

PROVISION HOME CARE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL NELSON (OWNER)
(601) 517-9707
Entity
Organization

Contact information

Practice address
837 GRAVES KEYS RD, BASSFIELD, MS 39421-4287
(601) 517-9707
Mailing address
837 GRAVES KEYS RD, BASSFIELD, MS 39421-4287
(601) 517-9707

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
MS

Other

Enumeration date
02/15/2015
Last updated
02/17/2015
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