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General NPI Number Information
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NPI Number | 1902360571
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Entity Type | Organization
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Legal Business Name | RESILIENCE HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 15 NORTHTOWN DR STE C
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City | JACKSON
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State | MS
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Zip | 39211-3048
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Country | US
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Telephone | 601-624-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 308 DEER HOLW
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City | BRANDON
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State | MS
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Zip | 39047-6468
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Country | US
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Telephone | 601-624-0585
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MS. KIM JOHNSON
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Credential |
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Telephone | 601-624-0585
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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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