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General NPI Number Information
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NPI Number | 1144730466
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Entity Type | Organization
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Legal Business Name | AFNB HOME CARE LLC
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 1675 LAKELAND DR STE 203
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City | JACKSON
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State | MS
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Zip | 39216-4843
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Country | US
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Telephone | 601-345-4141
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Fax | 601-345-2571
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Provider Business Mailing Address
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Address Line | PO BOX 60366
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City | LAFAYETTE
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State | LA
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Zip | 70596-0366
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Country | US
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Telephone | 337-233-4778
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Fax | 337-233-4779
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Authorized Official
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Title or Position | CEO
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Name | JOHN FACKRELL
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Credential |
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Telephone | 337-233-4778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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