Provider Demographics
NPI:1154304491
Name:HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:HOME HEALTH CARE SERVICES, INC.
Other - Org Name:ADORATION HOME HEALTH AND HOSPICE CARE MISSISSIPPI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEMBERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2321
Mailing Address - Street 1:805 N WHITTINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-7101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 S MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2698
Practice Address - Country:US
Practice Address - Phone:662-887-1202
Practice Address - Fax:662-887-3170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2024-01-11
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-07-25
Provider Licenses
StateLicense IDTaxonomies
MS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS000770559Medicaid
MS0770559Medicaid
MS000070066OtherBCBS
MS25Q7101005Medicare ID - Type UnspecifiedYAZOO CITY BRANCH ID #
MS000070066OtherBCBS
MS0770559Medicaid
MS25Q7101004Medicare ID - Type UnspecifiedROLLING FORK BRANCH ID #
MS25-7101Medicare PIN