Individual provider · Type 1 NPI
Lanita Shavonn Granger, HOMECARE PROVIDER
Adult Care Home Facility · Meridian, MS
NPI number
1447906565
Active
Practice location
314 43rd Ave
Meridian, MS 39307-6800
Fax (601) 453-5920
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Homemaker | 376J00000X | LCB20190000075 (MS) |
| Adult Care Home Facility Primary | 311ZA0620X | None listed |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1447906565
Lanita Shavonn Granger, HOMECARE PROVIDER's National Provider Identifier is 1447906565, issued on Feb 28, 2022. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Meridian, MS. The record was last updated on Feb 8, 2024.