MEDICARE: SIGNIFICANT HEALTHCARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care	SIL7363	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699960740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGNIFICANT HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	9550 BREEDEN DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-2149
Country	:	US
Telephone Number	:	225-357-2433
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 BREEDEN DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-2149
Country	:	US
Telephone Number	:	225-357-2433
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MRS. STEPHANIE RENA JOHNSON
Credential	:
Telephone Number	:	225-355-8103

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	09/12/2007

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Directions to “SIGNIFICANT HEALTHCARE SERVICES, LLC ” Practice Location

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