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NPI Code Detail

MEDICARE: HOLY ANGELS RESIDENTIAL FACILITY

MEDICARE: HOLY ANGELS RESIDENTIAL FACILITY
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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1841938073
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLY ANGELS RESIDENTIAL FACILITY
Provider Business Mailing Address
First Line : 10450 ELLERBE RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-7712
Country : US
Telephone Number : 318-797-8500
Fax Number :
Provider Business Practice Location Address
First Line : 10450 ELLERBE RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-7730
Country : US
Telephone Number : 318-797-8500
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF FINANCE
Name : CHRISTINA LANDRY HORNE
Credential : CPA
Telephone Number : 318-797-8500
Provider Enumeration Date : 05/26/2022
Last Update Date : 05/27/2022

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Directions to “HOLY ANGELS RESIDENTIAL FACILITY ” Practice Location

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