Healthcare Provider Details

I. General information

NPI: 1881716553
Provider Name (Legal Business Name): KELLIES SITTING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 CLEVELAND RD
BOYCE LA
71409-9284
US

IV. Provider business mailing address

123 CLEVELAND RD
BOYCE LA
71409-9284
US

V. Phone/Fax

Practice location:
  • Phone: 318-793-8453
  • Fax: 318-793-5378
Mailing address:
  • Phone: 318-793-8453
  • Fax: 318-793-5378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberPCA10531
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. GLENDA ARLENE WASHINGTON
Title or Position: DIRECTOR
Credential:
Phone: 318-793-8453