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General NPI Number Information
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NPI Number | 1033155510
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Entity Type | Organization
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Legal Business Name | COLLINS AND COLLINS I LLC
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 316 CENTRAL AVENUE
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City | LAUREL
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State | MS
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Zip | 39440
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Country | US
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Telephone | 601-425-3047
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Fax | 601-425-3048
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Provider Business Mailing Address
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Address Line | 316 CENTRAL AVENUE
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City | LAUREL
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State | MS
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Zip | 39440
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Country | US
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Telephone | 601-425-3047
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Fax | 601-425-3048
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MRS. JANICE DOUGLAS
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Credential |
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Telephone | 601-425-3047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 251601
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License Number State | MS
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