Provider Demographics
NPI:1932961083
Name:CHOSEN RUBY LLC
Entity Type:Organization
Organization Name:CHOSEN RUBY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYELL
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-493-9406
Mailing Address - Street 1:2616 DEERCROSS PL
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5025
Mailing Address - Country:US
Mailing Address - Phone:504-493-9406
Mailing Address - Fax:
Practice Address - Street 1:2616 DEERCROSS PL
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5025
Practice Address - Country:US
Practice Address - Phone:504-493-9406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care