# LA BODEGA INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AmeraCare Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891870929
- **Authorized official:** MILTON R MIZE (OWNER/PRESIDENT)
- **Authorized official phone:** (985) 635-6900

## Contact information

- **Practice address:** 1579 HIGHWAY 51, PONCHATOULA, LA 70454-6374
- **Practice address phone:** (985) 635-6900
- **Practice address fax:** (985) 635-6936
- **Mailing address:** 327 W 21ST AVE, COVINGTON, LA 70433-3153
- **Mailing address phone:** (985) 635-6900
- **Mailing address fax:** (985) 635-6936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 922 | LA | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 04/27/2021