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General NPI Number Information
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NPI Number | 1912904707
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Entity Type | Organization
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Legal Business Name | MODERN HOME HEALTH, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 15781 PROFESSIONAL PLZ
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City | HAMMOND
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State | LA
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Zip | 70403-1452
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Country | US
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Telephone | 985-429-0210
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Fax | 985-429-2635
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Provider Business Mailing Address
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Address Line | 15781 PROFESSIONAL PLZ
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City | HAMMOND
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State | LA
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Zip | 70403-1452
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Country | US
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Telephone | 985-429-0210
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Fax | 985-429-2635
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DAVID JOSEPH MARTIN
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Credential |
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Telephone | 504-491-4988
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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 | 710
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License Number State | LA
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