Healthcare Provider Details

I. General information

NPI: 1275185498
Provider Name (Legal Business Name): DDC SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400A OCEAN SPRINGS RD
OCEAN SPRINGS MS
39564-4404
US

IV. Provider business mailing address

11247 KARLI LN
BILOXI MS
39532-8026
US

V. Phone/Fax

Practice location:
  • Phone: 228-334-5304
  • Fax: 228-334-5246
Mailing address:
  • Phone: 228-334-5304
  • Fax: 228-334-5246

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: CYNTHIA PICARD
Title or Position: MANAGING OWNER
Credential:
Phone: 228-334-5304