Healthcare Provider Details

I. General information

NPI: 1396511424
Provider Name (Legal Business Name): ANCHOR HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 BENTON RD STE D202
BOSSIER CITY LA
71111-3554
US

IV. Provider business mailing address

2285 BENTON RD STE D202
BOSSIER CITY LA
71111-3554
US

V. Phone/Fax

Practice location:
  • Phone: 318-459-7960
  • Fax: 318-459-7961
Mailing address:
  • Phone: 318-459-7960
  • Fax: 318-459-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER JACKSON
Title or Position: CEO
Credential:
Phone: 318-459-7960