| Pace Synervations Llc | |
|
350 W Woodrow Wilson Ave Ste 3140 Jackson MS 39213-7664 | |
| (769) 251-5751 | |
| Not Available |
| Full Name | Pace Synervations Llc |
|---|---|
| Speciality | Social Worker |
| Location | 350 W Woodrow Wilson Ave Ste 3140, Jackson, Mississippi |
| Authorized Official Name and Position | Latesha W Thomas (CEO-OWNER) |
| Authorized Official Contact | 7692515751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pace Synervations Llc 350 W Woodrow Wilson Ave Ste 3140 Jackson MS 39213-7664 Ph: (769) 251-5751 | Pace Synervations Llc 350 W Woodrow Wilson Ave Ste 3140 Jackson MS 39213-7664 Ph: (769) 251-5751 |
| NPI Number | 1992419196 |
|---|---|
| Provider Enumeration Date | 01/11/2023 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 3870965254 |
|---|---|
| Medicare Enrollment ID | O20230213000712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992419196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Latesha Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063851848 PECOS PAC ID: 7810369204 Enrollment ID: I20230214001345 |
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