Organization
INTREPID OF LOUISIANA INC
Active
Other names
Intrepid USA Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PARKER (CCO)
(214) 445-3750
Entity
Organization
Contact information
Practice address
1200 HOSPITAL DR STE 8, OPELOUSAS, LA 70570-6552
(337) 546-0997
(337) 546-0452
Mailing address
14841 DALLAS PKWY STE 625, DALLAS, TX 75254-7641
(214) 445-3750
(952) 285-6327
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1169
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1404357
—
LA
01
—
19D0894636
CLIA CERTIFICATE OF WAIVER
LA
Enumeration date
11/18/2005
Last updated
11/08/2022
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