Organization
SOUTH REGIONAL PERSONAL CARE SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNAH HICKERSON (OWNER)
(225) 367-1646
Entity
Organization
Contact information
Practice address
10319 OLD HAMMOND HWY STE B1, BATON ROUGE, LA 70816-8288
(225) 367-1467
(225) 456-5094
Mailing address
10319 OLD HAMMOND HWY STE B1, BATON ROUGE, LA 70816-8288
(225) 367-1467
(225) 456-5094
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2203783544
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2203783544
—
LA
Enumeration date
11/07/2017
Last updated
11/07/2017
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