Healthcare Provider Details

I. General information

NPI: 1063112985
Provider Name (Legal Business Name): D NICOLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 VILLAGE ST STE A
SLIDELL LA
70458-5300
US

IV. Provider business mailing address

114 VILLAGE ST STE A
SLIDELL LA
70458-5300
US

V. Phone/Fax

Practice location:
  • Phone: 833-733-1333
  • Fax: 985-214-9012
Mailing address:
  • Phone: 833-733-1333
  • Fax: 985-214-9012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. DONDRA N HILLS
Title or Position: ADMINISTRATOR
Credential:
Phone: 504-296-1030