Provider Demographics
NPI: | 1740697275 |
---|---|
Name: | SINCERE HOME CARE LLC. |
Entity type: | Organization |
Organization Name: | SINCERE HOME CARE LLC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | QWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | DEBORAH |
Authorized Official - Middle Name: | DIANE |
Authorized Official - Last Name: | WRIGHT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 601-862-9706 |
Mailing Address - Street 1: | 5911 HOLMES CT |
Mailing Address - Street 2: | |
Mailing Address - City: | JACKSON |
Mailing Address - State: | MS |
Mailing Address - Zip Code: | 39213-9784 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 601-321-9653 |
Mailing Address - Fax: | 769-233-8894 |
Practice Address - Street 1: | 5911 HOLMES CT |
Practice Address - Street 2: | |
Practice Address - City: | JACKSON |
Practice Address - State: | MS |
Practice Address - Zip Code: | 39213 |
Practice Address - Country: | US |
Practice Address - Phone: | 601-321-9653 |
Practice Address - Fax: | 769-233-8094 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-07-16 |
Last Update Date: | 2014-11-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MS | M8257 | 101YM0800X |
104100000X, 1041C0700X, 133NN1002X, 163WC0400X, 172A00000X, 225XM0800X, 372500000X, 374U00000X, 376K00000X | ||
MS | R691135 | 163WC1500X, 163WH0200X, 163WP0807X |
MS | 1081 | 310400000X, 376J00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163WC1500X | Nursing Service Providers | Registered Nurse | Community Health | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | Group - Multi-Specialty |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 163WP0807X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |
No | 172A00000X | Other Service Providers | Driver | Group - Multi-Specialty | |
No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health | Group - Multi-Specialty |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | Group - Multi-Specialty | |
No | 372500000X | Nursing Service Related Providers | Chore Provider | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 376J00000X | Nursing Service Related Providers | Homemaker | Group - Multi-Specialty | |
No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Multi-Specialty |