=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225590433
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARE STARTS AT HOME
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2019
-----------------------------------------------------
Last Update Date | 04/05/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 BEVERLY DR
-----------------------------------------------------
City | WEST POINT
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39773-7980
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-295-1895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 BEVERLY DR
-----------------------------------------------------
City | WEST POINT
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39773-7980
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-295-1895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. GINGER SHEA GILL
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 662-295-1895
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------