Organization
AT HOME - HOME CARE INC
Active
Other names
At Home - Home Care Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADY JOHN CASTILLE BSN (OWNER)
(337) 789-1006
Entity
Organization
Contact information
Practice address
4400A AMBASSADOR CAFFERY PKWY STE 228, LAFAYETTE, LA 70508-6706
(337) 393-6106
(337) 464-9872
Mailing address
4400A AMBASSADOR CAFFERY PKWY STE B, LAFAYETTE, LA 70508-6706
(337) 393-6106
(337) 464-9872
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205462017
NOW WAIVER
LA
05
—
1205462017
—
LA
01
—
1326673286
NOW
LA
05
—
1326673286
—
LA
Enumeration date
03/11/2020
Last updated
08/19/2020
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