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General NPI Number Information
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NPI Number | 1144753948
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Entity Type | Organization
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Legal Business Name | COMPLETE PERSONAL CARE SERVICES LLC
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 140 ASPEN SQ STE B
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-5323
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Country | US
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Telephone | 225-380-1613
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Fax | 225-243-4349
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Provider Business Mailing Address
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Address Line | 140 ASPEN SQ STE B
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-5323
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Country | US
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Telephone | 225-380-1613
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Fax | 225-243-4349
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Authorized Official
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Title or Position | CEO
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Name | MRS. HOPE CLARK
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Credential |
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Telephone | 225-380-1613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2203783218
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License Number State | LA
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