Healthcare Provider Details

I. General information

NPI: 1417808270
Provider Name (Legal Business Name): A HAND UP REHABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 BOWMAR AVE
VICKSBURG MS
39180-4603
US

IV. Provider business mailing address

1651 OAK RIDGE RD
VICKSBURG MS
39183-9310
US

V. Phone/Fax

Practice location:
  • Phone: 850-363-0012
  • Fax:
Mailing address:
  • Phone: 817-800-0612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA0900X
TaxonomyAmputee Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TRIVA WATTS SANDERS
Title or Position: OWNER/CEO
Credential: CRC, CCSCC
Phone: 817-800-0612