Provider Demographics
NPI:1992374938
Name:ALL AT HOME PERSONAL CARE AND RESPITE SERVICE
Entity Type:Organization
Organization Name:ALL AT HOME PERSONAL CARE AND RESPITE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-754-6987
Mailing Address - Street 1:1836 E LINCOLN RD SE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-8701
Mailing Address - Country:US
Mailing Address - Phone:601-754-6987
Mailing Address - Fax:601-299-5362
Practice Address - Street 1:1836 E LINCOLN RD SE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-8701
Practice Address - Country:US
Practice Address - Phone:601-754-6987
Practice Address - Fax:601-299-5362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care