Healthcare Provider Details

I. General information

NPI: 1225501240
Provider Name (Legal Business Name): INTEGRITY HOME CARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905B MISSION 66 STE 4
VICKSBURG MS
39180-3707
US

IV. Provider business mailing address

1905B MISSION 66 STE 4
VICKSBURG MS
39180-3707
US

V. Phone/Fax

Practice location:
  • Phone: 601-301-2172
  • Fax: 601-510-9434
Mailing address:
  • Phone: 601-301-2172
  • Fax: 601-510-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MAKETTA JENNINGS
Title or Position: OWNER
Credential:
Phone: 601-618-8632