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General NPI Number Information
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NPI Number | 1841181641
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Entity Type | Organization
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Legal Business Name | BEWISE HEALTH AGENCY
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1003 EASTVIEW ST
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City | JACKSON
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State | MS
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Zip | 39203-3119
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Country | US
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Telephone | 601-715-9111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | CLINTON
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State | MS
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Zip | 39060-0297
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Country | US
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Telephone | 601-715-9111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CYNTORIA JOHNSON
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Credential |
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Telephone | 601-715-9111
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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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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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