Healthcare Provider Details

I. General information

NPI: 1033744727
Provider Name (Legal Business Name): DLC HOME CARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8869 CENTRE ST STE B1
SOUTHAVEN MS
38671-1725
US

IV. Provider business mailing address

8869 CENTRE ST STE B1
SOUTHAVEN MS
38671-1725
US

V. Phone/Fax

Practice location:
  • Phone: 901-438-5876
  • Fax:
Mailing address:
  • Phone: 901-438-5876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LATARSHA MITCHELL
Title or Position: PRESIDENT
Credential:
Phone: 901-438-5876