# CLASSIC CARE OF BATON ROUGE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUPRA Home Care of Shreveport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265732960
- **Authorized official:** LARRY BUTLER (PRESIDENT/CEO)
- **Authorized official phone:** (504) 837-5557

## Contact information

- **Practice address:** 1321 SIBLEY RD, SUITE A, MINDEN, LA 71055-5100
- **Practice address phone:** (318) 371-1801
- **Practice address fax:** (318) 371-1810
- **Mailing address:** PO BOX 6588, METAIRIE, LA 70009-6588
- **Mailing address phone:** (504) 837-5557
- **Mailing address fax:** (504) 833-3466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | PCA 15368 | LA | Yes |

## Other

- **Enumeration date:** 10/27/2010
- **Last updated:** 10/27/2010