Provider Demographics
NPI:1194060921
Name:CAREWELL PERSONAL CARE SERVICES, LLC
Entity type:Organization
Organization Name:CAREWELL PERSONAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETISCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDYESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-620-7990
Mailing Address - Street 1:PO BOX 17822
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-7822
Mailing Address - Country:US
Mailing Address - Phone:601-620-7990
Mailing Address - Fax:
Practice Address - Street 1:1524 ADELINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6262
Practice Address - Country:US
Practice Address - Phone:601-620-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care