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NPI Code Detail

MEDICARE: ALPHA & OMEGA HOME HELP, LLC

MEDICARE: ALPHA & OMEGA HOME HELP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2385H00000XRespite Care
3253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1649683947
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA & OMEGA HOME HELP, LLC
Provider Business Mailing Address
First Line : PO BOX 1100
Second Line :
City : JACKSON
State : MS
Zip : 39215-1100
Country : US
Telephone Number : 601-605-9055
Fax Number :
Provider Business Practice Location Address
First Line : 107 PAWNEE PL
Second Line :
City : CLINTON
State : MS
Zip : 39056-3140
Country : US
Telephone Number : 601-605-9055
Fax Number :
Authorized Official
Title or Position : OWNER/MANAGER
Name : MRS. KIMBERLY SANDIFER
Credential :
Telephone Number : 601-605-9055
Provider Enumeration Date : 06/04/2014
Last Update Date : 06/04/2014

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Directions to “ALPHA & OMEGA HOME HELP, LLC ” Practice Location

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