Healthcare Provider Details

I. General information

NPI: 1427361666
Provider Name (Legal Business Name): CARING HANDS PERSONAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 COLUMBIA AVE. STE. B
PRENTISS MS
39474
US

IV. Provider business mailing address

PO BOX 177
PRENTISS MS
39474-0177
US

V. Phone/Fax

Practice location:
  • Phone: 601-792-9329
  • Fax: 601-792-0664
Mailing address:
  • Phone: 601-792-9329
  • Fax: 601-792-0664

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: KIMBERLY GHOLAR
Title or Position: OWNER
Credential:
Phone: 601-441-3537