Organization
CARING HANDS PPEC OF VICKSBURG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBIE CLARK RN (OWNER, RN)
(318) 323-1930
Entity
Organization
Contact information
Practice address
3419 WISCONSIN AVE, VICKSBURG, MS 39180-5330
(601) 629-0505
(601) 629-0502
Mailing address
PO BOX 2403, MONROE, LA 71207-2403
(318) 323-1930
(318) 323-1013
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005574549
—
MS
Enumeration date
02/25/2016
Last updated
03/03/2023
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