1326206251 NPI number — L A HOMECARE 1 INC

Table of content: (NPI 1326206251)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326206251 NPI number — L A HOMECARE 1 INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
L A HOMECARE 1 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:
LA HOMECARE INC
Provider Other Organization Name Type Code:
5
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:
1326206251
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1647
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATALBANY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70451-1647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-878-2273
Provider Business Mailing Address Fax Number:
985-878-9534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15636 HWY 1064
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATALBANY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-878-2273
Provider Business Practice Location Address Fax Number:
985-878-9534
Provider Enumeration Date:
05/28/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
BASIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISRTATOR
Authorized Official Telephone Number:
985-320-0779

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X , with the licence number:  1633232 , 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: 1633241 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1320382 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1633232 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".