Healthcare Provider Details

I. General information

NPI: 1174280077
Provider Name (Legal Business Name): KLH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 DEACON ST
AVONDALE LA
70094-2425
US

IV. Provider business mailing address

320 DEACON ST
AVONDALE LA
70094-2425
US

V. Phone/Fax

Practice location:
  • Phone: 504-920-3300
  • Fax:
Mailing address:
  • Phone: 504-920-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ALASANDRA LEONARD
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 509-203-3300