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General NPI Number Information
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NPI Number | 1144533167
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Entity Type | Organization
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Legal Business Name | CHASE PERSONAL CARE HOME SERVICES
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 222 LINGLEWOOD DR
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City | BYRAM
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State | MS
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Zip | 39272-6018
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Country | US
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Telephone | 601-613-9971
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Fax |
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Provider Business Mailing Address
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Address Line | 222 LINGLEWOOD DR
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City | BYRAM
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State | MS
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Zip | 39272-6018
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Country | US
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Telephone | 601-613-9971
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. KYLA WEARY CHASE
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Credential | RN
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Telephone | 601-613-9971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 163WC1500X
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License Number State | MS
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