=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033401971
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SINCERITY SERVICES,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2011
-----------------------------------------------------
Last Update Date | 05/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8680 JEFFERSON HWY SUITE 349
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70809-2259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-316-3376
-----------------------------------------------------
Fax | 225-246-8398
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 86726
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70879-6726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-316-3376
-----------------------------------------------------
Fax | 225-246-8398
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MS. LORA ANN GRAY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 225-316-3376
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------