Organization
LOUISIANA HOMECARE OF MISS-LOU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD D. STELLY (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
200 SERIO BLVD, FERRIDAY, LA 71334-2015
(318) 336-2323
(318) 336-2631
Mailing address
P.O. BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1000
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1400637
—
LA
01
—
190030782Z
BLUE CROSS BLUE SHIELD OF
LA
Enumeration date
06/02/2006
Last updated
04/03/2019
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