Organization
SOUTH REGIONAL PERSONAL CARE SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNAH HICKERSON (OWNER)
(225) 367-1649
Entity
Organization
Contact information
Practice address
10319 OLD HAMMOND HWY STE B1, BATON ROUGE, LA 70816-8288
(225) 367-1649
Mailing address
13811 PARKWAY DR, DENHAM SPRINGS, LA 70726-8819
(225) 333-2178
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2203782592
LA
251E00000X
Home Health Agency
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Other
Enumeration date
10/11/2017
Last updated
10/11/2017
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