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General NPI Number Information
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NPI Number | 1417310863
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE HEART PERSONAL CARE & RESPITE SERVICES LLC
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Dates
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Enumeration Date | 04/02/2016
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Last Update Date | 04/02/2016
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Provider Practice Location Address
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Address Line | 425 OLD FOXWORTH RD
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City | COLUMBIA
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State | MS
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Zip | 39429-8244
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Country | US
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Telephone | 601-441-4337
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Fax | 601-633-5117
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Provider Business Mailing Address
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Address Line | 373 JOE PITTMAN RD
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City | FOXWORTH
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State | MS
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Zip | 39483-4272
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Country | US
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Telephone | 601-441-4337
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Fax | 601-633-5117
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | GLADYS LEE
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Credential |
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Telephone | 601-441-4337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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