Provider Demographics
NPI:1912655200
Name:SITTING ANGELS CUSTOMIZED SENIOR CARE
Entity Type:Organization
Organization Name:SITTING ANGELS CUSTOMIZED SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:176-979-8583
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:MS
Mailing Address - Zip Code:39117-0367
Mailing Address - Country:US
Mailing Address - Phone:769-798-5839
Mailing Address - Fax:
Practice Address - Street 1:194 E RATLIFF ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:MS
Practice Address - Zip Code:39117-3270
Practice Address - Country:US
Practice Address - Phone:769-798-5839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health