Provider Demographics
NPI:1528374790
Name:DEVOTED SENIOR CARE, LLC
Entity Type:Organization
Organization Name:DEVOTED SENIOR CARE, LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-689-2300
Mailing Address - Street 1:3317 FREDERICA ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6082
Mailing Address - Country:US
Mailing Address - Phone:270-689-2300
Mailing Address - Fax:
Practice Address - Street 1:3317 FREDERICA ST
Practice Address - Street 2:SUITE 11
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6082
Practice Address - Country:US
Practice Address - Phone:270-689-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500112253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care