Healthcare Provider Details

I. General information

NPI: 1902359755
Provider Name (Legal Business Name): VETERSANS AT HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4480 GENERAL DEGAULLE DR SUITE 208
NEW ORLEANS LA
70131-6941
US

IV. Provider business mailing address

4480 GENERAL DEGAULLE DR SUITE 208
NEW ORLEANS LA
70131-6941
US

V. Phone/Fax

Practice location:
  • Phone: 504-338-9295
  • Fax: 504-267-5716
Mailing address:
  • Phone: 504-338-9295
  • Fax: 504-267-5716

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: MRS. THERESA PETERS FISHER
Title or Position: OWNER
Credential:
Phone: 504-338-9295