Provider Demographics
NPI:1972608339
Name:HEALING HANDS HOSPICE AND SITTING SERVICE
Entity Type:Organization
Organization Name:HEALING HANDS HOSPICE AND SITTING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-621-9850
Mailing Address - Street 1:110 YAZOO AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-1100
Mailing Address - Country:US
Mailing Address - Phone:662-621-9850
Mailing Address - Fax:662-621-9849
Practice Address - Street 1:1742 N STATE ST
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-6620
Practice Address - Country:US
Practice Address - Phone:662-621-9850
Practice Address - Fax:662-621-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS149251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS251635Medicare Oscar/Certification