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General NPI Number Information
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NPI Number | 1326673286
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Entity Type | Organization
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Legal Business Name | AT HOME - HOME CARE INC
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 4400A AMBASSADOR CAFFERY PKWY STE 228
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City | LAFAYETTE
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State | LA
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Zip | 70508-6706
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Country | US
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Telephone | 337-393-6106
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Fax | 337-464-9872
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Provider Business Mailing Address
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Address Line | 4400A AMBASSADOR CAFFERY PKWY STE B
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City | LAFAYETTE
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State | LA
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Zip | 70508-6706
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Country | US
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Telephone | 337-393-6106
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Fax | 337-464-9872
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRADY JOHN CASTILLE
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Credential | BSN
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Telephone | 337-789-1006
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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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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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