Healthcare Provider Details

I. General information

NPI: 1821203191
Provider Name (Legal Business Name): JOAN ARMSTRONG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S HIGHLAND DR
TUPELO MS
38801-4510
US

IV. Provider business mailing address

PO BOX 912
VERONA MS
38879-0912
US

V. Phone/Fax

Practice location:
  • Phone: 662-231-5580
  • Fax: 662-253-5751
Mailing address:
  • Phone: 662-231-5580
  • Fax: 662-253-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOAN LASHALL JUNEARICK
Title or Position: OWNER
Credential:
Phone: 662-231-5580