My Personal Care Attendant LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

2203781269 Issued in LA

Legal business name

MY PERSONAL CARE ATTENDANT LLC

Doing business as

MyPCA

Practice address

106 Catalpa St
Monroe, LA 71201-7419

Phone

(318) 387-3545

Fax

(318) 387-3541

NPI assigned

Oct 1, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Roderick Jenkins

Title

Owner

Phone

(318) 387-3545

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• MyPCA Doing business as

Locations

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1598135683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CATALPA ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017419",
            "telephone_number": "318-387-3545",
            "fax_number": "318-387-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CATALPA ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017419",
            "telephone_number": "318-387-3545",
            "fax_number": "318-387-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PERSONAL CARE ATTENDANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-387-3545",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "LA",
            "license": "2203781269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140473",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031658",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327135",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyPCA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Monroe, LA
• Providers in Monroe, LA by specialty
• In Home Supportive Care Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.