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General NPI Number Information
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NPI Number | 1972874154
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Entity Type | Organization
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Legal Business Name | INFINITY PERSONAL CARE
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 30163 WALKER NORTH RD STE F
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City | WALKER
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State | LA
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Zip | 70785-7302
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Country | US
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Telephone | 225-667-0083
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Fax | 225-667-0093
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Provider Business Mailing Address
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Address Line | 30163 WALKER NORTH RD STE F
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City | WALKER
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State | LA
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Zip | 70785-7302
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Country | US
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Telephone | 225-667-0083
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Fax | 225-667-0093
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KATRINA PERKINS
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Credential |
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Telephone | 225-667-0083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | RC 13078
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License Number State | LA
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