MEDICARE: HYTEK HOME HEALTH AGENCY, INC.

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	251E00000X	Home Health Agency	326	LA

General Provider Information

NPI Number	:	1174709059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYTEK HOME HEALTH AGENCY, INC.

Provider Business Mailing Address
First Line	:	1901 OAK PARK BLVD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8915
Country	:	US
Telephone Number	:	337-562-1140
Fax Number	:	337-562-1142

Provider Business Practice Location Address
First Line	:	1909 OAK PARK BLVD
Second Line	:	SUITE A
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8915
Country	:	US
Telephone Number	:	337-475-7575
Fax Number	:	337-494-7256

Authorized Official
Title or Position	:	DIRECTOR OF ADMINISTRATION
Name	:	MS. KATHLEEN M MILLER
Credential	:	BS
Telephone Number	:	337-562-1140

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	06/25/2012

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