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General NPI Number Information
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NPI Number | 1316314941
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Entity Type | Organization
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Legal Business Name | WASHINGTON HOME HEALTH AGENCY, LLC
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 3402 WISCONSIN AVE STE 10
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City | VICKSBURG
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State | MS
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Zip | 39180-5378
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Country | US
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Telephone | 601-218-7280
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Fax | 601-501-1168
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Provider Business Mailing Address
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Address Line | 3402 WISCONSIN AVE STE 10
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City | VICKSBURG
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State | MS
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Zip | 39180-5378
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Country | US
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Telephone | 601-218-7280
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Fax | 601-501-1168
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MISS NATASHA NICOLE WASHINGTON
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Credential |
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Telephone | 601-218-7280
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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 | MS
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