Mid- State Home Health Agency Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

354 Issued in LA

Legal business name

MID- STATE HOME HEALTH AGENCY INC

Practice address

710 Versailles Blvd
Alexandria, LA 71303-2351

Phone

(318) 443-9739

Fax

(318) 443-9811

NPI assigned

Apr 11, 2006

Last updated

Jun 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark A Brown, C.P.A

Title

Owner/Administrator

Phone

(318) 443-9739

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1124081831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032351",
            "telephone_number": "318-443-9739",
            "fax_number": "318-443-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032351",
            "telephone_number": "318-443-9739",
            "fax_number": "318-443-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID- STATE HOME HEALTH AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "318-443-9739",
        "authorized_official_credential": "C.P.A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1402656",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.