Organization
MARTHA'S CARE PCA AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN BOOTH (CO-OWNER)
60154394882
Entity
Organization
Contact information
Practice address
791 GOODHOPE ROAD, BASSFIELD, MS 39421
(601) 543-9482
Mailing address
791 GOODHOPE ROAD, BASSFIELD, MS 39421
(601) 543-9482
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
253Z00000X
MS
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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