Organization
LIFE AT HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAISY W HOLMES MSN,RN (EXECUTIVE DIRECTOR)
(337) 463-3595
Entity
Organization
Contact information
Practice address
736 N PINE ST, DERIDDER, LA 70634-2812
(337) 463-3595
(337) 463-3595
Mailing address
736 N PINE ST, DERIDDER, LA 70634-2812
(337) 463-3595
(337) 463-3595
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
12352
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118036
—
LA
Enumeration date
04/27/2007
Last updated
03/20/2015
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