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General NPI Number Information
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NPI Number | 1447242482
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Entity Type | Organization
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Legal Business Name | ARK-LA-TEX HOME HEALTH INC.
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 7591 FERN AVE STE 1503
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City | SHREVEPORT
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State | LA
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Zip | 71105-5748
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Country | US
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Telephone | 318-747-6180
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Fax | 318-746-2771
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Provider Business Mailing Address
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Address Line | 7591 FERN AVE STE 1503
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City | SHREVEPORT
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State | LA
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Zip | 71105-5748
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Country | US
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Telephone | 318-747-6180
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Fax | 318-746-2771
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MRS. JODI PENNINGTON
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Credential |
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Telephone | 615-453-1029
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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 | 311
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License Number State | LA
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