=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790444511
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INFINITY PLUS CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2021
-----------------------------------------------------
Last Update Date | 08/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1111 S RANGE AVE
-----------------------------------------------------
City | DENHAM SPRINGS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70726-4800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-998-3948
-----------------------------------------------------
Fax | 225-529-3859
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2525 ONEAL LN APT 313
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70816-3413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-205-4075
-----------------------------------------------------
Fax | 225-529-3859
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER/OWNER
-----------------------------------------------------
Name | FELECIA R JACOB
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-205-4075
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------