Organization Name: | LIFE AT HOME LLC |
NPI Number: | 1205041845 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAISY W HOLMES (EXECUTIVE DIRECTOR) |
Mailing Address: | 736 North Pine Street Deridder |
State: | LA US |
Postal Code: | 70634 |
Phone Number: | 3374633595 |
Fax Number: | 3374633919 |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 03/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 12352 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |