1972972354 NPI number — HOLISTIC HOUSE CALLS LLC

Table of content: DR. ROBIN A. BAKER M.D. (NPI 1881699718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972972354 NPI number — HOLISTIC HOUSE CALLS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLISTIC HOUSE CALLS LLC
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:
Provider Other Organization Name Type Code:
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:
1972972354
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1152
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VILLE PLATTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70586-1152
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-459-4082
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1352 TATE COVE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VILLE PLATTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70586
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-459-4082
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MOODY
Authorized Official First Name:
RASHAUNA
Authorized Official Middle Name:
GUILLORY
Authorized Official Title or Position:
BUSINESS OWNER/NURSE PRACTITIONER
Authorized Official Telephone Number:
337-459-4082

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  AP06458 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2307835 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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