Healthcare Provider Details

I. General information

NPI: 1679819890
Provider Name (Legal Business Name): GLOBAL HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 06/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 PRUITT RD
WEST POINT MS
39773-4517
US

IV. Provider business mailing address

558 CREEKSIDE DR 205
LOWELL IN
46356-7921
US

V. Phone/Fax

Practice location:
  • Phone: 318-331-3619
  • Fax: 219-690-3343
Mailing address:
  • Phone: 318-331-3619
  • Fax: 219-690-3343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberR878106
License Number StateMS

VIII. Authorized Official

Name: MRS. EDNA J COLLINS
Title or Position: DIRECTOR
Credential: DIRECTOR
Phone: 318-331-3619