Provider Demographics
NPI:1780230185
Name:AVIS CARING HANDS HOME SERVICE
Entity Type:Organization
Organization Name:AVIS CARING HANDS HOME SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:AVIS
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING
Authorized Official - Phone:601-832-9168
Mailing Address - Street 1:1419 COOKS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-4376
Mailing Address - Country:US
Mailing Address - Phone:601-832-9168
Mailing Address - Fax:601-982-8177
Practice Address - Street 1:1419 COOKS AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-4376
Practice Address - Country:US
Practice Address - Phone:601-832-9168
Practice Address - Fax:601-982-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health