MEDICARE: ALL STAR HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1932529252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL STAR HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4660 MCWILLIE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39206-5621
Country	:	US
Telephone Number	:	704-267-9445
Fax Number	:	678-457-9038

Provider Business Practice Location Address
First Line	:	4660 MCWILLIE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39206-5621
Country	:	US
Telephone Number	:	704-267-9445
Fax Number	:	678-457-9038

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	ANTOINE DENNARD SMITH
Credential	:
Telephone Number	:	704-267-9445

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	04/25/2014

Similar Medicare Providers

1417518929 — TERESA S HOLMES
Practice Location Address:

3406 REDMOND AVE
JACKSON, MS
39213-5621

Practice Phone: 601-519-7243
Practice Fax:

1114740842 — EL ROI COUNSELING SERVICES, LLC
Practice Location Address:

4659 TERRY RD
JACKSON, MS
39212-5621

Practice Phone: 769-218-9517
Practice Fax:

1053356410 — BLANCHE MAE BELL ARNP
Practice Location Address:

4510 OFFICE PARK DR
JACKSON, MS
39206-6016

Practice Phone: 225-433-3172
Practice Fax: 601-228-4471

1235134065 — MISSISSIPPI MEDICAL, INC
Practice Location Address:

5836 N COMMERCE PLZ
JACKSON, MS
39206-2936

Practice Phone: 601-952-0124
Practice Fax: 601-978-1736

1497747661 — DR. GAIL V BENTON D.D.S.
Practice Location Address:

4463 N STATE ST
JACKSON, MS
39206

Practice Phone: 601-714-2908
Practice Fax:

1659366854 — DR. MICHELLE J GIBSON M.D.
Practice Location Address:

5440 WATKINS DR , SUITE B
JACKSON, MS
39206-2034

Practice Phone: 601-364-2726
Practice Fax: 601-364-2731

Directions to “ALL STAR HEALTHCARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.