Organization
OPTIMUM PERSONAL CARE & SITTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARNELL KITCHENS (EXECUTIVE DIRECTOR)
(601) 259-4602
Entity
Organization
Contact information
Practice address
4500 N STATE ST, JACKSON, MS 39206-5307
(601) 259-4602
Mailing address
4500 N STATE ST, JACKSON, MS 39206-5307
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08559576
—
MS
Enumeration date
03/14/2017
Last updated
03/14/2017
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