1932579414 NPI number — NATIONS HEALTHCARE, L.L.C.

Table of content: (NPI 1932579414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932579414 NPI number — NATIONS HEALTHCARE, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONS HEALTHCARE, L.L.C.
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:
GRACE HOME HEALTH
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:
1932579414
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1602 W PINHOOK RD STE 301
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:
70508-3735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-889-5950
Provider Business Mailing Address Fax Number:
337-988-3300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1602 W PINHOOK RD STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70508-3735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-889-5950
Provider Business Practice Location Address Fax Number:
337-988-3300
Provider Enumeration Date:
09/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MANNING
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
337-889-5950

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1139 , 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: 1372137 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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