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General NPI Number Information
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NPI Number | 1972509271
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Entity Type | Organization
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Legal Business Name | INTERIM HEALTHCARE OF SOUTHEAST LA INC
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2424 EDENBORN AVE STE 430
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City | METAIRIE
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State | LA
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Zip | 70001-1845
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Country | US
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Telephone | 504-834-9000
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Fax | 504-834-9032
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Provider Business Mailing Address
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Address Line | 2424 EDENBORN AVE STE 430
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City | METAIRIE
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State | LA
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Zip | 70001-1845
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Country | US
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Telephone | 504-834-9000
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Fax | 504-834-9032
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Authorized Official
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Title or Position | CFO
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Name | MR. ELLIS D PREJEANT
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Credential |
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Telephone | 504-834-9000
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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 | 945
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License Number State | LA
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