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General NPI Number Information
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NPI Number | 1124547542
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Entity Type | Organization
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Legal Business Name | INFINITY ENTERPRISE LLC
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 09/18/2017
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Provider Practice Location Address
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Address Line | 64 FIRST COLONY CIR
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City | COLUMBUS
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State | MS
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Zip | 39702-7900
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Country | US
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Telephone | 662-435-5404
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Fax |
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Provider Business Mailing Address
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Address Line | 64 FIRST COLONY CIR
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City | COLUMBUS
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State | MS
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Zip | 39702-7900
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Country | US
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Telephone | 662-435-5404
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. ROSHUNICA ROCHELLE MURRAY
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Credential | RN
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Telephone | 662-435-5404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1154241
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R877178
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License Number State | MS
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