Organization
SPECIALTY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAKEYLA SHARELLE MANNING LPN (OWNER)
(601) 613-2666
Entity
Organization
Contact information
Practice address
16 LAKEVIEW DR, RAYMOND, MS 39154-7614
(601) 613-2666
(601) 857-0075
Mailing address
16 LAKEVIEW DRIVE, RAYMOND, MS 39154
(601) 613-2666
(601) 857-0075
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
P317056
MS
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
06/03/2011
Last updated
06/03/2011
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