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General NPI Number Information
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NPI Number | 1982184651
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Entity Type | Organization
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Legal Business Name | RUBY D'S LLC
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 2214 DOGWOOD LN
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City | JACKSON
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State | MS
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Zip | 39212-2353
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Country | US
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Telephone | 601-586-9523
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21331
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City | JACKSON
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State | MS
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Zip | 39289-2002
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Country | US
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Telephone | 601-586-9523
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. RUBY WASHINGTON
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Credential | CNA
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Telephone | 601-720-1382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MS
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Taxonomy #2
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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 | MS
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