=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306656319
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUELITE HOME HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2025
-----------------------------------------------------
Last Update Date | 01/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 BONNER ST
-----------------------------------------------------
City | HOLLY SPRINGS
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38635-2014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-882-2548
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 BONNER ST
-----------------------------------------------------
City | HOLLY SPRINGS
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38635-2014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-882-2548
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SHANTANIKA L HUNT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 662-882-2548
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------