Provider Demographics
NPI:1982184651
Name:RUBY D'S LLC
Entity Type:Organization
Organization Name:RUBY D'S LLC
Other - Org Name:LIFE HEALTHCARE STAFFING AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:601-720-1382
Mailing Address - Street 1:PO BOX 21331
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39289-2002
Mailing Address - Country:US
Mailing Address - Phone:601-586-9523
Mailing Address - Fax:
Practice Address - Street 1:2214 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-2353
Practice Address - Country:US
Practice Address - Phone:601-586-9523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health