Peggy Ann Clark
Individual provider Active NPI In Home Supportive Care Agency · Belzoni, MS
NPI 1609446863 · NPPES record last updated Jun 30, 2021
Key facts
- NPI
- 1609446863
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Practice address
- 809 Westside Dr
Belzoni, MS 39038-3055 - Phone
- (662) 836-9857
- NPI assigned
- Jun 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarks Caring Hearts LLC | Community/Behavioral Health | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
809 Westside Dr
Belzoni, MS 39038-3055
Mailing address
809 Westside Dr
Belzoni, MS 39038-3055
Phone (662) 836-9857
Other providers in Belzoni, MS
- Wilfredo Bullock
- Camp Kidz LLC
- Camp Reloaded LLC
- Ollie M Chapman
- Cindy Ragland Ira
- Clarks Caring Hearts LLC
- Sharon Coney
- Sean Shahzad Dailami-Pour
- Daniel B. Story II, DMD
- Delta Valley Development Corp #2
All providers in Belzoni, MS · In Home Supportive Care Agency in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.