Healthcare Provider Details

I. General information

NPI: 1245926369
Provider Name (Legal Business Name): SHARINGLYFE NON-MEDICAL CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 LEE DR
CLARKSDALE MS
38614-3320
US

IV. Provider business mailing address

1207 LEE DR
CLARKSDALE MS
38614-3320
US

V. Phone/Fax

Practice location:
  • Phone: 662-592-5143
  • Fax: 662-313-3364
Mailing address:
  • Phone: 662-592-5143
  • Fax: 662-313-3364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: LATORIA RENEEA BATTLES
Title or Position: OWNER
Credential:
Phone: 662-313-3364