Healthcare Provider Details

I. General information

NPI: 1306441175
Provider Name (Legal Business Name): HOMER MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 E COLLEGE ST
HOMER LA
71040-3202
US

IV. Provider business mailing address

620 E COLLEGE ST
HOMER LA
71040-3202
US

V. Phone/Fax

Practice location:
  • Phone: 318-927-2024
  • Fax: 318-371-3835
Mailing address:
  • Phone: 318-927-2024
  • Fax: 318-371-3835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: TINA HAYNES
Title or Position: CEO
Credential: RHIA
Phone: 318-927-2024