1649479007 NPI number — WE CARE HOME CARE

Table of content: (NPI 1649479007)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649479007 NPI number — WE CARE HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WE CARE HOME CARE
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:
1649479007
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
814 FIRST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JONESVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71343-2105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-339-4875
Provider Business Mailing Address Fax Number:
318-339-8061

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7210 PRAIRIE RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
WINNSBORO
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71295-6691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-435-4944
Provider Business Practice Location Address Fax Number:
318-435-4954
Provider Enumeration Date:
07/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COLLINS
Authorized Official First Name:
FAYE
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
318-339-4875

Provider Taxonomy Codes

  • Taxonomy code: 376J00000X , with the licence number:  6645 , 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: 1371343 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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