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General NPI Number Information
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NPI Number | 1467763854
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Entity Type | Organization
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Legal Business Name | EXQUISITE HOME CARE LLC
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 5640 READ BLVD STE 220
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City | NEW ORLEANS
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State | LA
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Zip | 70127-7805
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Country | US
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Telephone | 504-244-0455
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Fax |
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Provider Business Mailing Address
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Address Line | 2312 N HARPER DR
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City | HARVEY
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State | LA
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Zip | 70058-1334
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Country | US
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Telephone | 504-251-0493
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Fax |
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Authorized Official
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Title or Position | NURE PRACTITIONER
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Name | MS. BRANDI GRAY
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Credential |
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Telephone | 504-251-0493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 40178639K
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License Number State | LA
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