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General NPI Number Information
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NPI Number | 1134167349
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Entity Type | Organization
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Legal Business Name | INTENSIVE HOME HEALTHCARE, INC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 1633 CARTER ST.
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City | VIDALIA
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State | LA
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Zip | 71373-3207
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Country | US
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Telephone | 318-336-9030
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 CARTER ST
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City | VIDALIA
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State | LA
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Zip | 71373-3207
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Country | US
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Telephone | 318-336-9030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. ARLEVIA C MARTIN
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Credential | ADMINISITRATOR
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Telephone | 318-336-9030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1400106
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License Number State | LA
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