Healthcare Provider Details

I. General information

NPI: 1952266579
Provider Name (Legal Business Name): SHARE 4 CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 TREASURE LN
STARKVILLE MS
39759-8770
US

IV. Provider business mailing address

581 TREASURE LN
STARKVILLE MS
39759-8770
US

V. Phone/Fax

Practice location:
  • Phone: 662-640-4595
  • Fax:
Mailing address:
  • Phone: 662-640-4595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: TEQUILA SHREE BUSH-JONES
Title or Position: CASE MANAGEMENT
Credential: RN
Phone: 662-694-2437