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General NPI Number Information
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NPI Number | 1245820554
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Entity Type | Organization
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Legal Business Name | ST.OAKS CARE CENTER LLC
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 83 WHITE CHAPEL RD
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City | CARRIERE
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State | MS
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Zip | 39426-7473
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Country | US
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Telephone | 601-365-1438
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Fax |
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Provider Business Mailing Address
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Address Line | 83 WHITE CHAPEL RD
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City | CARRIERE
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State | MS
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Zip | 39426-7473
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Country | US
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Telephone | 601-365-1438
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD C HECK JR.
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Credential |
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Telephone | 601-365-1438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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