Provider Demographics
NPI:1295288793
Name:SENIORS FIRST HOMECARE
Entity type:Organization
Organization Name:SENIORS FIRST HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-275-5617
Mailing Address - Street 1:1045 DOGWOOD HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:NESBIT
Mailing Address - State:MS
Mailing Address - Zip Code:38651-8338
Mailing Address - Country:US
Mailing Address - Phone:901-275-5617
Mailing Address - Fax:
Practice Address - Street 1:1045 DOGWOOD HOLLOW DR
Practice Address - Street 2:
Practice Address - City:NESBIT
Practice Address - State:MS
Practice Address - Zip Code:38651-8338
Practice Address - Country:US
Practice Address - Phone:901-275-5617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS200733253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care