Healthcare Provider Details

I. General information

NPI: 1659379188
Provider Name (Legal Business Name): TRUCARE HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 FORSYTHE AVE STE A
MONROE LA
71201-3186
US

IV. Provider business mailing address

1523 TEXAS AVE
BASTROP LA
71220-4043
US

V. Phone/Fax

Practice location:
  • Phone: 318-281-8627
  • Fax: 318-281-5190
Mailing address:
  • Phone: 318-281-0000
  • Fax: 318-281-2753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1059
License Number StateLA

VIII. Authorized Official

Name: MR. GOODWIN GLADNEY
Title or Position: MANAGING PARTNER
Credential:
Phone: 318-281-0000