Healthcare Provider Details

I. General information

NPI: 1790021202
Provider Name (Legal Business Name): LITTLE BITS CAREGIVERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 CAJUN TRL NW
BROOKHAVEN MS
39601-4479
US

IV. Provider business mailing address

1325 CAJUN TRL NW
BROOKHAVEN MS
39601-4479
US

V. Phone/Fax

Practice location:
  • Phone: 601-823-5624
  • Fax: 601-823-5624
Mailing address:
  • Phone: 601-823-5624
  • Fax: 601-823-5624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateMS

VIII. Authorized Official

Name: MRS. CLAUDETTE BURCH ASHWORTH
Title or Position: OWNER
Credential:
Phone: 601-823-5624