Healthcare Provider Details

I. General information

NPI: 1285820514
Provider Name (Legal Business Name): 1ST HOME HEALTH KARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
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

Practice location:
  • Phone: 225-248-8028
  • Fax:
Mailing address:
  • Phone: 225-248-8028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPCA 14017
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BILSHANDA MARTIN
Title or Position: DIRECTOR
Credential:
Phone: 225-248-8028