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Organization

HOME HEALTH PROFESSIONAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JODY WILLIAMS (CEO)
(225) 667-2792
Entity
Organization

Contact information

Practice address
2550 FLORIDA BLVD SW, DENHAM SPRINGS, LA 70726-4951
(225) 667-2792
Mailing address
722 S RANGE AVE, DENHAM SPRINGS, LA 70726-4401
(225) 667-7279

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
625
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1405337
LA
Enumeration date
01/17/2008
Last updated
01/17/2008
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