Healthcare Provider Details
I. General information
NPI: 1700966843
Provider Name (Legal Business Name): BUDS RESPITE CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
132 W MILL RD
SARDIS MS
38666-2200
US
IV. Provider business mailing address
132 W MILL RD
SARDIS MS
38666-2200
US
V. Phone/Fax
- Phone: 662-487-1015
- Fax: 662-487-9229
- Phone: 662-487-1015
- Fax: 662-487-9229
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | 385H00000X |
| License Number State | MS |
VIII. Authorized Official
Name: MRS.
DEBORA
ANN
SYKES
Title or Position: CEO
Credential: LICENSE NURSE
Phone: 662-487-1015