Provider Demographics
NPI:1902439359
Name:CARING HEART PERSONAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:CARING HEART PERSONAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-869-0061
Mailing Address - Street 1:217 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-4007
Mailing Address - Country:US
Mailing Address - Phone:662-869-0061
Mailing Address - Fax:662-842-7972
Practice Address - Street 1:217 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-4007
Practice Address - Country:US
Practice Address - Phone:662-869-0061
Practice Address - Fax:662-842-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05228061Medicaid