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General NPI Number Information
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NPI Number | 1881559722
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Entity Type | Organization
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Legal Business Name | S.D. VENTURES
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 1136 BARLOW ROAD
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City | WICKLIFFE
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State | KY
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Zip | 42087
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Country | US
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Telephone | 270-210-8030
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 823
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City | PADUCAH
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State | KY
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Zip | 42002-0823
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANIQUA DICKERSON
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Credential |
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Telephone | 270-210-8030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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