Provider Demographics
NPI:1700966843
Name:BUDS RESPITE CARE
Entity Type:Organization
Organization Name:BUDS RESPITE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSE NURSE
Authorized Official - Phone:662-487-1015
Mailing Address - Street 1:132 W MILL RD
Mailing Address - Street 2:
Mailing Address - City:SARDIS
Mailing Address - State:MS
Mailing Address - Zip Code:38666-2200
Mailing Address - Country:US
Mailing Address - Phone:662-487-1015
Mailing Address - Fax:662-487-9229
Practice Address - Street 1:132 W MILL RD
Practice Address - Street 2:
Practice Address - City:SARDIS
Practice Address - State:MS
Practice Address - Zip Code:38666-2200
Practice Address - Country:US
Practice Address - Phone:662-487-1015
Practice Address - Fax:662-487-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS385H00000X385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0770425Medicaid