Healthcare Provider Details

I. General information

NPI: 1629258793
Provider Name (Legal Business Name): GOOD HANDS HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 W GROLEE ST
OPELOUSAS LA
70570-4222
US

IV. Provider business mailing address

524 W GROLEE ST
OPELOUSAS LA
70570-4222
US

V. Phone/Fax

Practice location:
  • Phone: 337-447-0293
  • Fax:
Mailing address:
  • Phone: 337-447-0293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number14028
License Number StateLA

VIII. Authorized Official

Name: MRS. LATRICIA TYLER
Title or Position: OWNER
Credential:
Phone: 337-692-3009