Provider Demographics
NPI:1437353752
Name:AT HOME HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:AT HOME HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:FELTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-786-9494
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MS
Mailing Address - Zip Code:39069-0009
Mailing Address - Country:US
Mailing Address - Phone:601-786-9494
Mailing Address - Fax:601-786-9493
Practice Address - Street 1:1264 MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:FAYETTE
Practice Address - State:MS
Practice Address - Zip Code:39069-5466
Practice Address - Country:US
Practice Address - Phone:601-786-9494
Practice Address - Fax:601-786-9493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based