Organization Name: | STA-HOME HOSPICE OF MISSISSIPPI INC |
NPI Number: | 1144491077 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIKE MCDOWELL (CFO) |
Mailing Address: | 406 Briarwood Dr Ste 200 Jackson |
State: | MS US |
Postal Code: | 392063060 |
Phone Number: | 6019565100 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2008 |
NPI Last Update Date: | 03/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 251G00000X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |