Healthcare Provider Details

I. General information

NPI: 1225536204
Provider Name (Legal Business Name): LOUISIANA IN-HOME PARTNER-III, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 01/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 N VICTOR II BLVD
MORGAN CITY LA
70380-1331
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 985-384-3478
  • Fax: 985-384-0560
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-233-5764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DONALD D. STELLY
Title or Position: VICE PRESIDENT
Credential:
Phone: 337-233-1307