Healthcare Provider Details

I. General information

NPI: 1942708854
Provider Name (Legal Business Name): CM SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 RAYMOND RD
JACKSON MS
39204-4583
US

IV. Provider business mailing address

PO BOX 16954
JACKSON MS
39236-6954
US

V. Phone/Fax

Practice location:
  • Phone: 601-779-1118
  • Fax: 769-572-5167
Mailing address:
  • Phone: 601-779-1118
  • Fax: 769-572-5167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MS. DONDRIA PALMER
Title or Position: OWNER
Credential: RN
Phone: 601-779-1118