Healthcare Provider Details
I. General information
NPI: 1922821123
Provider Name (Legal Business Name): RELIEF LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 N BURKE AVE
LONG BEACH MS
39560-4605
US
IV. Provider business mailing address
102 N BURKE AVE
LONG BEACH MS
39560-4605
US
V. Phone/Fax
- Phone: 228-284-2176
- Fax:
- Phone: 228-284-2176
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADDISON
SWEEBE
Title or Position: DIRECTOR
Credential:
Phone: 228-806-8914