Provider Demographics
NPI:1447762042
Name:SOUTH MISSISSIPPI HOME CARE, LLC
Entity Type:Organization
Organization Name:SOUTH MISSISSIPPI HOME CARE, LLC
Other - Org Name:SOUTH MS HOME CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PERSONAL CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:N
Authorized Official - Last Name:FIORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-967-7945
Mailing Address - Street 1:10536 AUTO MALL PKWY STE C3
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-3742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56128 DIAMONDHEAD DR E
Practice Address - Street 2:
Practice Address - City:DIAMONDHEAD
Practice Address - State:MS
Practice Address - Zip Code:39525
Practice Address - Country:US
Practice Address - Phone:228-627-1539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-04
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health