Healthcare Provider Details

I. General information

NPI: 1093555344
Provider Name (Legal Business Name): ARDEN HOME HEALTH OF NORTH MISSISSIPPI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 GALLERIA DR UNIT C-1
OXFORD MS
38655-4715
US

IV. Provider business mailing address

133 MAYFAIR RD
HATTIESBURG MS
39402-1464
US

V. Phone/Fax

Practice location:
  • Phone: 662-636-7636
  • Fax: 662-636-7637
Mailing address:
  • Phone: 601-582-6031
  • Fax:

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: ANTHONY ALAN BLAKENEY
Title or Position: CFO
Credential:
Phone: 601-498-7702