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Organization

GUARDIAN ANGEL HOMEMAKER SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAULETTE BUTLER PHD (ADMINISTRATOR)
(601) 732-8473
Entity
Organization

Contact information

Practice address
1192 HIGHWAY 13 S, MORTON, MS 39117-7987
(601) 732-8473
(601) 732-8037
Mailing address
41 S HALL RD, MORTON, MS 39117-8057
(601) 732-8473
(601) 732-8037

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
04970592
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04970592
MS
Enumeration date
03/05/2008
Last updated
03/05/2008
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