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General NPI Number Information
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NPI Number | 1144548181
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Entity Type | Organization
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Legal Business Name | CARING HANDS FAMILY HEALTH CARE CLINIC INC
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Dates
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Enumeration Date | 05/15/2010
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Last Update Date | 05/15/2010
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Provider Practice Location Address
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Address Line | 369 HIGHWAY 72
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City | BURNSVILLE
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State | MS
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Zip | 38833-9320
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Country | US
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Telephone | 662-665-2818
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 166
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City | BURNSVILLE
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State | MS
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Zip | 38833-0166
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Country | US
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Telephone | 662-665-2818
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TAMI BABETTE JOHNSON
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Credential | FNP
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Telephone | 662-665-2818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | R605972
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License Number State | MS
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