Basic Information
Provider Information
NPI: 1255389664
EntityType: 2
ReplacementNPI:  
OrganizationName: HOUSECALL HOME HEALTH, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AMEDISYS HOME HEALTH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2252922031
FaxNumber: 2252959678
Practice Location
Address1: 9200 NW 39TH AVE
Address2: SUITE 190
City: GAINESVILLE
State: FL
PostalCode: 326067331
CountryCode: US
TelephoneNumber: 3523720466
FaxNumber: 3523720824
Other Information
ProviderEnumerationDate: 05/05/2006
LastUpdateDate: 03/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LABORDE
AuthorizedOfficialFirstName: RONALD
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 2252922031
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X210100961FLY AgenciesHome Health 

No ID Information.


Home