Provider Demographics
NPI:1518675206
Name:RELIANCE HOME & COMMUNITY CARE, LLC
Entity Type:Organization
Organization Name:RELIANCE HOME & COMMUNITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:601-765-5041
Mailing Address - Street 1:PO BOX 1781
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:MS
Mailing Address - Zip Code:39428-1781
Mailing Address - Country:US
Mailing Address - Phone:601-765-5041
Mailing Address - Fax:
Practice Address - Street 1:404 N FIR AVE STE B
Practice Address - Street 2:
Practice Address - City:COLLINS
Practice Address - State:MS
Practice Address - Zip Code:39428-4201
Practice Address - Country:US
Practice Address - Phone:601-765-5041
Practice Address - Fax:601-765-3247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care