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DOROTHY JEANETTE JONES

Custodial Care Facility

Port Gibson, Mississippi

Provider NPI: 1902004013

Provider Information:
 DOROTHY JEANETTE JONES 


Practice Location:
1004 COLLEGE ST  PORT GIBSON, MS 39150 US
Tel: 601-437-3524  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N311Z00000XNursing & Custodial Care Facilities
Custodial Care Facility
Y385H00000XRespite Care Facility
Respite Care

Other Provider Identifiers:

IssuerNumberStateType
IN-HOME RESPITE0070580MS05
HOMEMAKER00770582MS05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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