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
515 WASHINGTON AVE # A, MANSFIELD, LA 71052-3105
(318) 871-8112
(318) 871-9013
Mailing address
515 WASHINGTON AVE # A, MANSFIELD, LA 71052-3105
(318) 871-8112
(318) 871-9013
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
10567
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460591
—
LA
Enumeration date
04/26/2007
Last updated
03/20/2015
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