NPIMap

Organization Active NPI

Life at Home LLC

  • In Home Supportive Care Agency
  • Mansfield, LA
National Provider Identifier
1659591444
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
10567 Issued in LA
Legal business name
LIFE AT HOME LLC
Practice address
515 Washington Ave # a
Mansfield, LA 71052-3105
Phone
(318) 871-8112
Fax
(318) 871-9013
NPI assigned
Apr 26, 2007
Last updated
Mar 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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) 463-3595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 10567 LA Primary

Addresses

Primary practice location

515 Washington Ave # a
Mansfield, LA 71052-3105

Mailing address

515 Washington Ave # a
Mansfield, LA 71052-3105
Phone (318) 871-8112

Other identifiers 1

IdentifierTypeStateIssuer
1460591MedicaidLA

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

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1659591444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 WASHINGTON AVE # A",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710523105",
            "telephone_number": "318-871-8112",
            "fax_number": "318-871-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 WASHINGTON AVE # A",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710523105",
            "telephone_number": "318-871-8112",
            "fax_number": "318-871-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2015-03-20",
        "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": "337-463-3595",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN,RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "LA",
            "license": "10567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460591",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.