MEDICARE: LAROUGE PERSONAL HOME CARE, 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	385H00000X	Respite Care
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1982275624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAROUGE PERSONAL HOME CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 485
Second Line	:
City	:	BAKER
State	:	LA
Zip	:	70704-0485
Country	:	US
Telephone Number	:	225-286-5291
Fax Number	:	225-341-8763

Provider Business Practice Location Address
First Line	:	9800 AIRLINE HWY STE 233
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-8195
Country	:	US
Telephone Number	:	225-993-0486
Fax Number	:	225-341-8763

Authorized Official
Title or Position	:	OWNER
Name	:	EBONY BROWN
Credential	:
Telephone Number	:	225-993-0486

Provider Enumeration Date	:	07/04/2021
Last Update Date	:	12/20/2022

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