Provider Demographics
NPI:1952625428
Name:COOKS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:COOKS HEALTHCARE, LLC
Other - Org Name:C&S STAFFING SERVICES, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CALRENEASE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:662-534-6789
Mailing Address - Street 1:611 MOSS HILL DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-3212
Mailing Address - Country:US
Mailing Address - Phone:662-534-6789
Mailing Address - Fax:662-534-6763
Practice Address - Street 1:611 MOSS HILL DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3212
Practice Address - Country:US
Practice Address - Phone:662-534-6789
Practice Address - Fax:662-534-6763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05978577Medicaid
MS06586521Medicaid