Organization Name: | A FIRST NAME BASIS HOME CARE |
NPI Number: | 1215309356 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAKE FACKRELL (CEO) |
Mailing Address: | 19267 Slemmer Rd Suite 201 Covington |
State: | LA US |
Postal Code: | 704338984 |
Phone Number: | 9858454701 |
Fax Number: | |
NPI Enumeration Date: | 10/28/2015 |
NPI Last Update Date: | 10/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 2203782464 |
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 |