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NPI 1245261502

NPI 1245261502 : CENTRE HOME CARE, LLC : CENTRE, AL

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General NPI Number Information
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    NPI Number           |    1245261502
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    Entity Type          |    Organization 
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    Legal Business Name  |    CENTRE HOME CARE, LLC 
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Dates
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    Enumeration Date     |    07/05/2006
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    Last Update Date     |    05/24/2024
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Provider Practice Location Address
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    Address Line         |    104C NORTHWOOD DR STE A-1 
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    City                 |    CENTRE
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    State                |    AL
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    Zip                  |    35960-1017
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    Country              |    US
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    Telephone            |    256-927-1144
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    Fax                  |    256-927-8068
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Provider Business Mailing Address
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    Address Line         |    PO BOX 51266 
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    City                 |    LAFAYETTE
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    State                |    LA
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    Zip                  |    70505-1266
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    Country              |    US
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    Telephone            |    337-233-1307
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    Fax                  |    337-443-4154
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     JOSHUA L PROFFITT 
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    Credential           |    
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    Telephone            |    337-233-1307
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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       |    
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    License Number State |    
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