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General NPI Number Information
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NPI Number | 1578745014
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Entity Type | Organization
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Legal Business Name | OUACHITA HOME CARE, LLC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 806 N 31ST ST STE A
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City | MONROE
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State | LA
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Zip | 71201-3945
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Country | US
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Telephone | 318-325-8004
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Fax | 318-325-8060
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Provider Business Mailing Address
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Address Line | 806 N 31ST ST STE A
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City | MONROE
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State | LA
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Zip | 71201-3945
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Country | US
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Telephone | 318-325-8004
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Fax | 318-325-8060
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | MRS. RONITA J CALHOUN
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Credential | RN
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Telephone | 318-537-0740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | PCA14018
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License Number State | LA
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