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General NPI Number Information
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NPI Number | 1235132374
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Entity Type | Organization
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Legal Business Name | LAFAYETTE GENERAL MEDICAL CENTER INC HOME HEALTH
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 201 AUDUBON BLVD STE 246
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City | LAFAYETTE
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State | LA
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Zip | 70503-2608
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Country | US
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Telephone | 337-289-8137
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Fax | 337-289-8138
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Provider Business Mailing Address
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Address Line | 201 AUDUBON BLVD STE 246
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City | LAFAYETTE
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State | LA
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Zip | 70503-2632
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Country | US
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Telephone | 337-289-8137
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Fax | 337-289-8138
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR OF NURSING
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Name | MRS. DEBRA A GOODLY
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Credential | R.N.
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Telephone | 337-289-8025
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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 | 163
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License Number State | LA
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