Healthcare Provider Details

I. General information

NPI: 1972538528
Provider Name (Legal Business Name): HOME AWAY FROM HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 HILLTOP AVE
FRANKLINTON LA
70438-1566
US

IV. Provider business mailing address

PO BOX 662
FRANKLINTON LA
70438-0662
US

V. Phone/Fax

Practice location:
  • Phone: 985-839-6706
  • Fax: 985-839-6783
Mailing address:
  • Phone: 985-839-6706
  • Fax: 985-839-6783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number842
License Number StateLA

VIII. Authorized Official

Name: SARA HOWARD
Title or Position: ADMINISTRATOR
Credential:
Phone: 985-839-6706