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General NPI Number Information
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NPI Number | 1225413966
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Entity Type | Organization
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Legal Business Name | COMBINED PERSONAL CARE SERVICES
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 5260 CEDAR PARK DR STE A
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City | JACKSON
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State | MS
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Zip | 39206-4131
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Country | US
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Telephone | 601-397-6575
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Fax | 769-251-2774
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Provider Business Mailing Address
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Address Line | 5260 CEDAR PARK DR STE A
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City | JACKSON
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State | MS
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Zip | 39206-4131
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Country | US
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Telephone | 601-397-6575
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Fax | 769-251-2774
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE SERVICES
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Name | MS. CHERISH R JOHNSON
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Credential | MPA
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Telephone | 601-214-4664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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