Healthcare Provider Details

I. General information

NPI: 1386449544
Provider Name (Legal Business Name): DSY ENTERPRISE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 E MAIN ST
LEXINGTON KY
40502-1668
US

IV. Provider business mailing address

710 E MAIN ST
LEXINGTON KY
40502-1668
US

V. Phone/Fax

Practice location:
  • Phone: 877-290-4149
  • Fax: 877-934-2359
Mailing address:
  • Phone: 877-290-4149
  • Fax: 877-934-2359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. SHMIEKA MICHELLE HURST
Title or Position: FOUNDER/CEO
Credential:
Phone: 765-729-8939