Healthcare Provider Details

I. General information

NPI: 1063804383
Provider Name (Legal Business Name): REMINISCENCE HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 10/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 JEFFERSON HWY 1315
BATON ROUGE LA
70816-6210
US

IV. Provider business mailing address

12400 JEFFERSON HWY 1315
BATON ROUGE LA
70816-6210
US

V. Phone/Fax

Practice location:
  • Phone: 225-439-4047
  • Fax: 225-349-8061
Mailing address:
  • Phone: 225-439-4047
  • Fax: 225-349-8061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. TRANCA LYNETTE FARVE
Title or Position: CEO/OWNER
Credential: LPN
Phone: 225-439-4047