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NPI 1497170260 · Home Health Agency · Gulfport, MS
Provider details
- NPI number
- 1497170260
- Entity type
- Organization
- Primary specialty
- Home Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Kwantrell Green, President(228) 547-4424
- License
- 03873054 (MS)
Specialties & taxonomies
Agencies
Ambulatory Health Care Facilities
Practice location
400 Legg Dr
Gulfport, MS 39503-3352
Phone: (228) 547-4424
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3162
Gulfport, MS 39505-3162
Registry dates
- Enumerated
- 2014-03-03
- Last updated
- 2014-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.