Organization
LIFE AT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAISY W HOLMES MSN,RN (EXECUTIVE DIRECTOR)
(337) 462-2745
Entity
Organization
Contact information
Practice address
736 N PINE ST, DERIDDER, LA 70634-2812
(337) 462-2745
(337) 462-2746
Mailing address
736 N PINE ST, DERIDDER, LA 70634-2812
(337) 462-2745
(337) 462-2746
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
12217
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118541
—
LA
Enumeration date
04/27/2007
Last updated
08/22/2020
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