Healthcare Provider Details

I. General information

NPI: 1376612077
Provider Name (Legal Business Name): ACT OF MERCY HOME CARE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 JEFFERSON TERRACE STE E
NEW IBERIA LA
70560
US

IV. Provider business mailing address

902 JEFFERSON TERRACE STE E
NEW IBERIA LA
70560
US

V. Phone/Fax

Practice location:
  • Phone: 337-365-6920
  • Fax: 866-281-1438
Mailing address:
  • Phone: 337-365-6920
  • Fax: 866-281-1438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number1479799
License Number StateLA

VIII. Authorized Official

Name: DENNIS GEORGE BROUSSARD
Title or Position: PRESIDENT OWNER
Credential:
Phone: 337-365-6920