Healthcare Provider Details

I. General information

NPI: 1508562430
Provider Name (Legal Business Name): CARRINGTON HOUSE HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 02/02/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 GROSS AVENUE
BURNSVILLE MS
38833-9702
US

IV. Provider business mailing address

26 GROSS AVENUE
BURNSVILLE MS
38833-9702
US

V. Phone/Fax

Practice location:
  • Phone: 662-424-2812
  • Fax:
Mailing address:
  • Phone: 662-424-2812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA KAY WILLIAMS
Title or Position: OWNER
Credential: RN
Phone: 662-424-2812