Organization
ALL STAR HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINE DENNARD SMITH (ADMINISTRATIVE DIRECTOR)
(704) 267-9445
Entity
Organization
Contact information
Practice address
4660 MCWILLIE DR, JACKSON, MS 39206-5621
(704) 267-9445
(678) 457-9038
Mailing address
4660 MCWILLIE DR, JACKSON, MS 39206-5621
(704) 267-9445
(678) 457-9038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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