Organization
NHIS CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANETTE HOWARD BOONE (EXECUTIVE DIRECTOR)
(662) 299-6207
Entity
Organization
Contact information
Practice address
104 MAPLE ST, GREENWOOD, MS 38930-7403
(662) 299-6207
Mailing address
104 MAPLE ST, GREENWOOD, MS 38930-7403
(662) 299-6207
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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