Organization Name: | LIFE AT HOME LLC |
NPI Number: | 1982824157 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAISY W HOLMES (EXECUTIVE DIRECTOR) |
Mailing Address: | 736 N Pine St Deridder |
State: | LA US |
Postal Code: | 706342812 |
Phone Number: | 3374622745 |
Fax Number: | 3374622746 |
NPI Enumeration Date: | 04/27/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 12217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |