Provider Demographics
NPI:1194062414
Name:HARMONIZING COMMUNITY CARE AGENCY
Entity type:Organization
Organization Name:HARMONIZING COMMUNITY CARE AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:H
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-613-4332
Mailing Address - Street 1:56 WOODRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2209
Mailing Address - Country:US
Mailing Address - Phone:601-613-4332
Mailing Address - Fax:769-257-6056
Practice Address - Street 1:56 WOODRIDGE PL
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:601-613-4332
Practice Address - Fax:769-257-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR864499385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04929031OtherIN HOUSE RESPITE PROVIDER NUMBER
MS385H00000XOtherTAXONOMY CODE