Provider Demographics
NPI:1093252942
Name:ASSISTED FAMILY SERVICES, LLC.
Entity Type:Organization
Organization Name:ASSISTED FAMILY SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-349-8272
Mailing Address - Street 1:1845 LINE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4611
Mailing Address - Country:US
Mailing Address - Phone:318-861-5928
Mailing Address - Fax:318-861-5921
Practice Address - Street 1:1845 LINE AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4611
Practice Address - Country:US
Practice Address - Phone:318-861-5928
Practice Address - Fax:318-861-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1466450Medicaid
LA1337765Medicaid
LA1333344Medicaid