Jeans Non Medical Care Respite

Organization Active NPI Respite Care · Sledge, MS

NPI 1154418481 · NPPES record last updated Dec 13, 2007

Key facts

NPI
1154418481
Entity type
Organization (NPI type 2)
Primary specialty
Respite Care 385H00000X
Legal business name
JEANS NON MEDICAL CARE RESPITE
Practice address
612 Broad Street
612
Sledge, MS 38270
Phone
(662) 382-8883
Fax
(662) 382-7776
NPI assigned
Oct 6, 2006
Organization subpart
No

Authorized official

Name
Ms. Ozie D Phipps, RESPITE PROVIDER
Title
Ceo
Phone
(662) 382-8883

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Jeans Non Medical Care Respite (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X Yes

Addresses

Primary practice location

612 Broad Street
612
Sledge, MS 38270

Mailing address

430 Williams Ave
P. O. Box 72
Sledge, MS 38670
Phone (662) 382-8883

Other identifiers

IdentifierTypeStateIssuer
07354332MedicaidMS

Other providers in Sledge, MS

All providers in Sledge, MS · Respite Care in Mississippi

Sources for this page

Verify at the official NPI Registry.