Healthcare Provider Details

I. General information

NPI: 1336992296
Provider Name (Legal Business Name): PICKING UP LOOSE ENDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8705 STONEWALL ST
OCEAN SPRINGS MS
39564-3639
US

IV. Provider business mailing address

8705 STONEWALL ST
OCEAN SPRINGS MS
39564-3639
US

V. Phone/Fax

Practice location:
  • Phone: 317-716-0477
  • Fax:
Mailing address:
  • Phone: 317-716-0477
  • Fax:

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: TYMICKA D MCCLENDON
Title or Position: CEO/OWNER
Credential: LPN
Phone: 317-716-0477