Organization
SUPERIOR PRO-CARE HOME PROVIDER
Active
Other names
Superior Pro Care Home Provider, Superior Pro-Care Home Provider
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA T CLAYTON EXECUTIVE MANAGER (PROVIDER)
(769) 447-5458
Entity
Organization
Contact information
Practice address
1421 DALTON ST, JACKSON, MS 39204-2806
(769) 447-5458
(769) 447-5451
Mailing address
1421 DALTON ST, JACKSON, MS 39204-2806
(769) 447-5458
(769) 447-5451
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MS
Other
Enumeration date
09/01/2017
Last updated
07/21/2022
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