MEDICARE: SOLOMON NORTH HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1043965106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLOMON NORTH HOMECARE LLC

Provider Business Mailing Address
First Line	:	8900 TILFORD RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2930
Country	:	US
Telephone Number	:	504-319-7792
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 SAINT MAURICE AVENUE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-7011
Country	:	US
Telephone Number	:	504-354-1227
Fax Number	:	318-441-5305

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	MRS. LISA L WILLIAMS
Credential	:	RN
Telephone Number	:	504-354-1227

Provider Enumeration Date	:	02/17/2022
Last Update Date	:	02/17/2022

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