Healthcare Provider Details

I. General information

NPI: 1164029930
Provider Name (Legal Business Name): JUST LIKE FAMILY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 E NORTHSIDE DR # 910E
JACKSON MS
39206-5533
US

IV. Provider business mailing address

910 E NORTHSIDE DR # 910E
JACKSON MS
39206-5533
US

V. Phone/Fax

Practice location:
  • Phone: 866-553-2659
  • Fax: 866-553-2659
Mailing address:
  • Phone: 866-553-2659
  • Fax: 866-553-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE CHAPMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LPN
Phone: 866-553-2659