Provider Demographics
NPI:1295156883
Name:RELIANT HOME CARE PLLC
Entity type:Organization
Organization Name:RELIANT HOME CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAWNCEE
Authorized Official - Middle Name:DANYIELL
Authorized Official - Last Name:VASSER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-436-7141
Mailing Address - Street 1:611 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-2488
Mailing Address - Country:US
Mailing Address - Phone:662-436-7141
Mailing Address - Fax:662-996-2224
Practice Address - Street 1:611 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2488
Practice Address - Country:US
Practice Address - Phone:662-436-7141
Practice Address - Fax:662-996-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR878106163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty