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Contact Information

STA-HOME HEALTH AGENCY OF JACKSON, INC.
130 FAIRMONT ST STE A
CLINTON, MS39056
 Phone: 601-961-4367
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
Indicates primary specialty

NPI Profile & details for STA-HOME HEALTH AGENCY OF JACKSON, INC.

NPI # 1356482749
LBN Legal business name STA-HOME HEALTH AGENCY OF JACKSON, INC.
Authorized official HEATHER SISCEL - (VP LEGAL)
Entity Organization
Organization subpart 1 No
Enumeration date 02/09/2007
Last updated 05/02/2024 - About 2 years ago
Identifiers
MS License # 11195
MS Medicaid 00770108
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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