Organization
SENIOR RESOURCES HEALTHCARE SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA CAPLES (CEO/DIRECTOR)
(769) 798-3490
Entity
Organization
Contact information
Practice address
623 ORCHID CT, JACKSON, MS 39206-2427
(769) 798-3490
(601) 991-1909
Mailing address
623 ORCHID CT, JACKSON, MS 39206-2427
(769) 798-3490
(601) 991-1909
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
05150307
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04775206
MEDICAID ELDERLY AND DISABLED WAIVER PROGRAM (RESPITE)
MS
01
—
05150307
MEDICAID ELDERLY AND DISABLED WAIVER PROGRAM ( HOMEMAKER)
MS
Enumeration date
09/22/2011
Last updated
09/22/2011
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