Provider Demographics
NPI:1619552593
Name:MISSION CARE SERVICES, INC.
Entity Type:Organization
Organization Name:MISSION CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-595-3903
Mailing Address - Street 1:PO BOX 681681
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36068-1681
Mailing Address - Country:US
Mailing Address - Phone:334-595-3903
Mailing Address - Fax:
Practice Address - Street 1:119 MACALLISTER RDG
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-1756
Practice Address - Country:US
Practice Address - Phone:334-595-3903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care