Provider Demographics
NPI:1093379943
Name:BARKSDALE, CASSANDRA DARLENE (BARKSDALE HOME CARE)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:DARLENE
Last Name:BARKSDALE
Suffix:
Gender:F
Credentials:BARKSDALE HOME CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 N OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:ELBERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30635-1444
Mailing Address - Country:US
Mailing Address - Phone:706-371-7167
Mailing Address - Fax:
Practice Address - Street 1:242 N OLIVER ST
Practice Address - Street 2:
Practice Address - City:ELBERTON
Practice Address - State:GA
Practice Address - Zip Code:30635-1444
Practice Address - Country:US
Practice Address - Phone:706-371-7167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty