Healthcare Provider Details

I. General information

NPI: 1346933900
Provider Name (Legal Business Name): C & K SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 GLUCKSTADT RD STE A
GLUCKSTADT MS
39110-7250
US

IV. Provider business mailing address

1265 GLUCKSTADT RD STE A
GLUCKSTADT MS
39110-7250
US

V. Phone/Fax

Practice location:
  • Phone: 601-624-8045
  • Fax:
Mailing address:
  • Phone: 601-624-8045
  • Fax: 601-265-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KEYTON CHANDLER RAMSEY
Title or Position: MANAGING MEMBER
Credential:
Phone: 601-624-8045