Healthcare Provider Details
I. General information
NPI: 1124420047
Provider Name (Legal Business Name): 1ST HOME HEALTH KARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2014
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11440 LAKE SHERWOOD AVE N STE F
BATON ROUGE LA
70816-0408
US
IV. Provider business mailing address
11440 LAKE SHERWOOD AVE N STE F
BATON ROUGE LA
70816-0408
US
V. Phone/Fax
- Phone: 225-248-8028
- Fax:
- Phone: 225-248-8028
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | HC0007333 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BILSHANDA
MARTIN
Title or Position: DIRECTOR
Credential:
Phone: 225-248-8028