Provider Demographics
NPI:1144494022
Name:OBP HOMEMAKER SERVICES, INC.
Entity type:Organization
Organization Name:OBP HOMEMAKER SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:601-743-5121
Mailing Address - Street 1:931 FRANK MCDANIEL RD
Mailing Address - Street 2:
Mailing Address - City:DE KALB
Mailing Address - State:MS
Mailing Address - Zip Code:39328-7653
Mailing Address - Country:US
Mailing Address - Phone:601-743-5121
Mailing Address - Fax:601-743-5127
Practice Address - Street 1:931 FRANK MCDANIEL RD
Practice Address - Street 2:
Practice Address - City:DE KALB
Practice Address - State:MS
Practice Address - Zip Code:39328-7653
Practice Address - Country:US
Practice Address - Phone:601-743-5121
Practice Address - Fax:601-743-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS376J00000X305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03175271Medicaid