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General NPI Number Information
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NPI Number | 1437353752
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Entity Type | Organization
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Legal Business Name | AT HOME HOSPICE CARE, INC.
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 1264 MAIN STREET SUITE B
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City | FAYETTE
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State | MS
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Zip | 39069-5466
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Country | US
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Telephone | 601-786-9494
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Fax | 601-786-9493
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | FAYETTE
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State | MS
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Zip | 39069-0009
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Country | US
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Telephone | 601-786-9494
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Fax | 601-786-9493
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Authorized Official
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Title or Position | DIRECTOR ADMINISTRATION
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Name | MRS. DOROTHY JEANETTE FELTON
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Credential | RN
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Telephone | 601-786-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MS
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