Healthcare Provider Details

I. General information

NPI: 1386112225
Provider Name (Legal Business Name): ANCHOR OF HOPE HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S LAKE ARTHUR AVE STE 6
JENNINGS LA
70546-5766
US

IV. Provider business mailing address

1817 LINCOLN ST
LAKE CHARLES LA
70601-1252
US

V. Phone/Fax

Practice location:
  • Phone: 337-263-5780
  • Fax:
Mailing address:
  • Phone: 337-263-5780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ERICA M. DANTLEY
Title or Position: CEO
Credential:
Phone: 337-263-5780