Organization Name: | SAINT JOHNS RESPITE SERVICES |
NPI Number: | 1275900813 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROLYN S JOHNSON (ADMINISTRATOR) |
Mailing Address: | 1027 French Rd Indianola |
State: | MS US |
Postal Code: | 387519605 |
Phone Number: | 6627560928 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2015 |
NPI Last Update Date: | 08/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |