Healthcare Provider Details

I. General information

NPI: 1053227991
Provider Name (Legal Business Name): WILSON'S INTEGRITY STAFFING & HEALTHCARE (WISH) AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 JOHNNY RUSSELL DRIVE
MOORHEAD MS
38761-0036
US

IV. Provider business mailing address

PO BOX 36
MOORHEAD MS
38761-0036
US

V. Phone/Fax

Practice location:
  • Phone: 662-378-7508
  • Fax:
Mailing address:
  • Phone: 662-378-7508
  • 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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STAR J WILSON
Title or Position: CEO
Credential: RN
Phone: 662-378-7508