NPIMap

Organization Active NPI

Life at Home, LLC

  • Community Based Hospice Care Agency
  • Deridder, LA
National Provider Identifier
1114141314
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
12351 Issued in LA
Legal business name
LIFE AT HOME, LLC
Practice address
736 N Pine St
Deridder, LA 70634-2812
Phone
(337) 462-2745
Fax
(337) 462-2746
NPI assigned
Apr 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Daisy W Holmes, MSN,RN
Title
Executive Director
Phone
(337) 462-2745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 12351 LA Primary

Addresses

Primary practice location

736 N Pine St
Deridder, LA 70634-2812

Mailing address

736 N Pine St
Deridder, LA 70634-2812
Phone (337) 462-2745

Other identifiers 9

IdentifierTypeStateIssuer
1118036MedicaidLA
1370932MedicaidLA
1466841MedicaidLA
1179299MedicaidLA
1460591MedicaidLA
1118541MedicaidLA
1528544MedicaidLA
1122734MedicaidLA
1134767MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Life Home LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

736 N Pine St
Deridder, LA 70634
Phone (337) 462-2745

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114141314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342812",
            "telephone_number": "337-462-2745",
            "fax_number": "337-462-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342812",
            "telephone_number": "337-462-2745",
            "fax_number": "337-462-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "DAISY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "337-462-2745",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN,RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "12351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1118036",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1370932",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1466841",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1179299",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460591",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1118541",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528544",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1122734",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134767",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.