Healthcare Provider Details

I. General information

NPI: 1912390865
Provider Name (Legal Business Name): LHC SENIORS ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 HIGHWAY 80 E
CLINTON MS
39056-5123
US

IV. Provider business mailing address

PO BOX 880
JACKSON MS
39205-0880
US

V. Phone/Fax

Practice location:
  • Phone: 601-624-5397
  • Fax: 601-354-6866
Mailing address:
  • Phone: 601-624-5397
  • Fax: 601-354-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENISE ELEY
Title or Position: PRISDENT
Credential:
Phone: 601-354-7866