Provider Demographics
NPI:1255900056
Name:SPECIAL CARE PLUS HOMEHEALTH LLC
Entity type:Organization
Organization Name:SPECIAL CARE PLUS HOMEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS-COAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:601-454-5504
Mailing Address - Street 1:110 ROBINSON CV
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-9435
Mailing Address - Country:US
Mailing Address - Phone:601-454-5504
Mailing Address - Fax:
Practice Address - Street 1:110 ROBINSON CV
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-9435
Practice Address - Country:US
Practice Address - Phone:601-454-5504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care