Healthcare Provider Details

I. General information

NPI: 1689511461
Provider Name (Legal Business Name): 3 GEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 HIGHWAY 84 W
COLLINS MS
39428-4929
US

IV. Provider business mailing address

45 HIGHWAY 84 W
COLLINS MS
39428-4929
US

V. Phone/Fax

Practice location:
  • Phone: 769-223-2803
  • Fax:
Mailing address:
  • Phone: 769-223-2803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DASHARA BOOTH
Title or Position: OWNER
Credential:
Phone: 769-223-2803