NPIMap

Organization Active NPI

Companion Care of Swla

  • In Home Supportive Care Agency
  • Deridder, LA
National Provider Identifier
1467788976
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
PCA15305 Issued in 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
Last updated
Apr 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Mr. Mark Richard Wallace, OWNER
Title
Chief Administrator
Phone
(337) 396-1899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X PCA15305 LA Primary

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

National Provider Directory

National Provider Directory
Tax ID family
Companion Care of Southwest Louisiana7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1014 N Pine St
Deridder, LA 70634
Phone (337) 463-3550

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1467788976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014A N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342818",
            "telephone_number": "337-463-3550",
            "fax_number": "337-462-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342818",
            "telephone_number": "337-463-3550",
            "fax_number": "337-462-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPANION CARE OF SWLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "337-396-1899",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "LA",
            "license": "PCA15305",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 21, 2010; 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.