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General NPI Number Information
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NPI Number | 1710777503
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Entity Type | Organization
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Legal Business Name | BOLDENS DEPENDABLE PRIVATE SITTING LLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 591 NORTHPARK DR
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City | RIDGELAND
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State | MS
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Zip | 39157-5174
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Country | US
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Telephone | 769-232-0646
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Fax |
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Provider Business Mailing Address
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Address Line | 591 NORTHPARK DR STE G
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City | RIDGELAND
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State | MS
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Zip | 39157-5174
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Country | US
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Telephone | 769-232-0646
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHYMEKA BOLDEN
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Credential |
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Telephone | 769-232-0646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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