Healthcare Provider Details

I. General information

NPI: 1770085821
Provider Name (Legal Business Name): WE CARE HOME SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 03/28/2020
Certification Date: 03/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 CASTLE HILL DR
JACKSON MS
39204-5232
US

IV. Provider business mailing address

2330 CASTLE HILL DR
JACKSON MS
39204-5232
US

V. Phone/Fax

Practice location:
  • Phone: 228-304-7968
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MYESHIA HOLLOWAY
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 769-524-4545