Organization
LEAF RIVER HOME HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS GACHASSIN (EXECUTIVE VICE PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
308 NORTH FRONT STREET, SUITE E, RICHTON, MS 39476-2205
(601) 788-2912
(601) 788-6763
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
9081
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070626
—
MS
01
—
70225
BLUE CROSS BLUE SHIELD OF
MS
Enumeration date
06/02/2006
Last updated
07/12/2022
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