| All Star Healthcare Llc | |
|
4660 Mcwillie Dr Jackson MS 39206-5621 | |
| (704) 267-9445 | |
| (678) 457-9038 |
| Full Name | All Star Healthcare Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4660 Mcwillie Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Antoine Dennard Smith (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 7042679445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| All Star Healthcare Llc 4660 Mcwillie Dr Jackson MS 39206-5621 Ph: (704) 267-9445 | All Star Healthcare Llc 4660 Mcwillie Dr Jackson MS 39206-5621 Ph: (704) 267-9445 |
| NPI Number | 1932529252 |
|---|---|
| Provider Enumeration Date | 04/25/2014 |
| Last Update Date | 04/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932529252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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