Healthcare Provider Details
I. General information
NPI: 1114644051
Provider Name (Legal Business Name): BKD PERSONAL ASSISTANCE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2022
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2505 SPRING AVE SW
DECATUR AL
35601-7314
US
IV. Provider business mailing address
2505 SPRING AVE SW
DECATUR AL
35601-7314
US
V. Phone/Fax
- Phone: 256-260-0725
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOANNE
K
LESKOWICZ
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 414-918-5000