Provider Demographics
NPI:1235847096
Name:BY YOUR SIDE HOME CARE, LLC
Entity Type:Organization
Organization Name:BY YOUR SIDE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALESHA
Authorized Official - Middle Name:PATTON
Authorized Official - Last Name:PRIDGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-372-4883
Mailing Address - Street 1:3026 AUCTION DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32448-7714
Mailing Address - Country:US
Mailing Address - Phone:850-372-4883
Mailing Address - Fax:850-331-1583
Practice Address - Street 1:401 N FOSTER ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-4554
Practice Address - Country:US
Practice Address - Phone:850-372-4883
Practice Address - Fax:850-331-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care