Provider Demographics
NPI:1770127003
Name:SACRED HEARTS HOME CARE LLC
Entity type:Organization
Organization Name:SACRED HEARTS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LASHON
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-806-5088
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:MS
Mailing Address - Zip Code:39663-0308
Mailing Address - Country:US
Mailing Address - Phone:601-806-5088
Mailing Address - Fax:601-806-5089
Practice Address - Street 1:141 JEFFERSON STREET SUITE C
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MS
Practice Address - Zip Code:39654-3965
Practice Address - Country:US
Practice Address - Phone:601-806-5088
Practice Address - Fax:601-806-5089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty