Provider Demographics
NPI:1386730174
Name:DS PERSONAL CARE INC
Entity type:Organization
Organization Name:DS PERSONAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SINGLETARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-255-9714
Mailing Address - Street 1:109 CALIFORNIA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108
Mailing Address - Country:US
Mailing Address - Phone:505-255-9714
Mailing Address - Fax:505-255-5418
Practice Address - Street 1:109 CALIFORNIA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108
Practice Address - Country:US
Practice Address - Phone:505-255-9714
Practice Address - Fax:505-255-5418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMF1564251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMF1564Medicaid