Companion Care of Swla
Organization Active NPI In Home Supportive Care Agency · Deridder, LA
NPI 1467788976 · NPPES record last updated Apr 21, 2010
Key facts
- NPI
- 1467788976
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- PCA15305 (LA)
- Legal business name
- COMPANION CARE OF SWLA
- Practice address
- 1014 N Pine St
Deridder, LA 70634-2818 - Phone
- (337) 463-3550
- Fax
- (337) 462-8012
- NPI assigned
- Oct 19, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Mark Richard Wallace, OWNER
- Title
- Chief Administrator
- Phone
- (337) 396-1899
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Companion Care of Southwest Louisiana
Locations
1014 N Pine St
Deridder, LA 70634
Phone (337) 463-3550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | PCA15305 | LA | Yes |
Addresses
Primary practice location
1014 N Pine St
Deridder, LA 70634-2818
Mailing address
1014A N Pine St
Deridder, LA 70634-2818
Phone (337) 463-3550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15305 | Other | LA | PCA |
| PCA 15351 | Medicaid | LA |
Other providers in Deridder, LA
- CLHG-Leesville
- CLHG-Leesville
- Companion Care of Southwest Louisiana
- Companion Care of Swla
- Companion Care of Swla
- Companion Care of Swla
- Concord Medical Group, PLLC
- Kaitlyn M. Connors
- Jennifer Lee Cooley
- Kaylyn Ann Cooley
All providers in Deridder, LA · In Home Supportive Care Agency in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.