Provider Demographics
NPI:1447851159
Name:RUBYS GENTLE TOUCH HOME CARE LLC
Entity type:Organization
Organization Name:RUBYS GENTLE TOUCH HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-213-4115
Mailing Address - Street 1:6163 E LAMAR ST STE C
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-8267
Mailing Address - Country:US
Mailing Address - Phone:228-213-4115
Mailing Address - Fax:
Practice Address - Street 1:6163 E LAMAR ST STE C
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-8267
Practice Address - Country:US
Practice Address - Phone:228-213-4115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care