Organization
VITAL WELLNES BILOXI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTENETTE JOANN AVERETT (NURSE MANAGER)
(228) 219-1314
Entity
Organization
Contact information
Practice address
770 WATER ST, BILOXI, MS 39530-4220
(228) 265-2229
Mailing address
770 WATER ST, BILOXI, MS 39530-4220
(228) 285-2229
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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