=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669576963
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIQUE HOME HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2006
-----------------------------------------------------
Last Update Date | 10/05/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5525 S SHERWOOD FOREST BLVD STE A
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70816-6093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-293-9230
-----------------------------------------------------
Fax | 225-293-9747
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5525 S SHERWOOD FOREST BLVD STE A
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70816-6093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-293-9230
-----------------------------------------------------
Fax | 225-293-9747
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. LYNETTE CUTNO GORDON
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 225-293-9230
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1034
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1114
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------