Provider Demographics
NPI:1619001864
Name:TOTAL HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:TOTAL HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:P
Authorized Official - Last Name:KILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:662-247-1254
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-0908
Mailing Address - Country:US
Mailing Address - Phone:662-453-7708
Mailing Address - Fax:662-453-9856
Practice Address - Street 1:922 HIGHWAY 82 W
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930
Practice Address - Country:US
Practice Address - Phone:662-453-7708
Practice Address - Fax:662-453-9856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770454Medicaid
MS00070522Medicaid
MS09476371Medicaid