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General NPI Number Information
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NPI Number | 1417171935
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Entity Type | Organization
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Legal Business Name | REGIONAL PCA SERVICES-NORTHEAST, LLC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 1205 NORTH 18TH STREET SUITE 207
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City | MONROE
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State | LA
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Zip | 71201
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Country | US
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Telephone | 318-323-0471
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Fax | 318-323-4783
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Provider Business Mailing Address
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Address Line | 8352 BLUEBONNET BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70810
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Country | US
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Telephone | 225-928-8989
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Fax | 225-928-8990
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHARLES LANPHIER
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Credential |
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Telephone | 225-928-8989
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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 | 10481
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License Number State | LA
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