Provider Demographics
NPI:1104347889
Name:OUR HOUSE PERSONAL CARE SERVICES
Entity type:Organization
Organization Name:OUR HOUSE PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:NEWMAN
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-394-9853
Mailing Address - Street 1:2537 BOBOLINK PL
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-8105
Mailing Address - Country:US
Mailing Address - Phone:662-394-9853
Mailing Address - Fax:662-873-6200
Practice Address - Street 1:149 COURT STREET
Practice Address - Street 2:
Practice Address - City:MAYERSVILLE
Practice Address - State:MS
Practice Address - Zip Code:39113
Practice Address - Country:US
Practice Address - Phone:662-394-9853
Practice Address - Fax:662-873-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty