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General NPI Number Information
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NPI Number | 1437068574
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Entity Type | Organization
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Legal Business Name | CC RELIABLE CARE SERVICES LLC
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 225 COMMUNITY DR
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City | FAYETTE
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State | MS
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Zip | 39069-7701
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Country | US
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Telephone | 601-809-3696
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Fax | 601-202-1708
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Provider Business Mailing Address
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Address Line | PO BOX 874
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City | FAYETTE
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State | MS
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Zip | 39069-0874
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Country | US
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Telephone | 601-786-1959
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Fax | 601-202-1708
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Authorized Official
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Title or Position | OWNER
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Name | CLARENCE LEE COLEMAN
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Credential |
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Telephone | 601-786-1959
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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 |
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