Organization
PERSONEL ELDER CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN HERMAN (OWNER)
(662) 334-6335
Entity
Organization
Contact information
Practice address
2353 HIGHWAY 1 S, 2353 SOUTH RIDGE CENTER, GREENVILLE, MS 38701-8337
(662) 334-6335
Mailing address
2353 SOUTH RIDGE CENTER, HWY1 SOUTH, GREENVILLE, MS 38701
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770570
—
MS
Enumeration date
12/20/2010
Last updated
12/20/2010
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