1497939706 NPI number — LEADING HEALTH CARE OF LA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497939706 NPI number — LEADING HEALTH CARE OF LA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEADING HEALTH CARE OF LA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LEADING HOME CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497939706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
206 LA RUE FRANCE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70508-3104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-930-0213
Provider Business Mailing Address Fax Number:
225-930-0233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4740 BLUEBONNET BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70809-9681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-930-0213
Provider Business Practice Location Address Fax Number:
225-930-0233
Provider Enumeration Date:
12/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
THERIOT
Authorized Official First Name:
BLAKE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF OPERATIONS
Authorized Official Telephone Number:
337-236-9111

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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