Provider Demographics
NPI:1902272834
Name:PRECISION CARE SERVICE OF MS.
Entity Type:Organization
Organization Name:PRECISION CARE SERVICE OF MS.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOMIKIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GARRETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-397-6625
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39205-0164
Mailing Address - Country:US
Mailing Address - Phone:601-397-6625
Mailing Address - Fax:601-300-2901
Practice Address - Street 1:2310 HIGHWAY 80 W STE C1122
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-2354
Practice Address - Country:US
Practice Address - Phone:601-397-6625
Practice Address - Fax:601-300-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care