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General NPI Number Information
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NPI Number | 1972454684
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Entity Type | Organization
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Legal Business Name | ANCHOR OF HOPE PEDIATRIC CARE, LLC
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Dates
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Enumeration Date | 02/07/2026
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 2208 MCLAURIN ST
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City | WAVELAND
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State | MS
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Zip | 39576-2664
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Country | US
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Telephone | 228-697-7406
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Fax |
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Provider Business Mailing Address
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Address Line | 606 CHARLESTON LN
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City | LONG BEACH
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State | MS
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Zip | 39560-3911
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Country | US
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Telephone | 228-697-7406
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMANDA FENNELL LEVENS
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Credential |
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Telephone | 228-697-7406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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