Provider Demographics
NPI:1093984809
Name:TOTAL CARE OPTIONS AGENCY, INC
Entity Type:Organization
Organization Name:TOTAL CARE OPTIONS AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:225-272-0100
Mailing Address - Street 1:12131 FLORIDA BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-2708
Mailing Address - Country:US
Mailing Address - Phone:225-272-0100
Mailing Address - Fax:225-272-0800
Practice Address - Street 1:12131 FLORIDA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-2708
Practice Address - Country:US
Practice Address - Phone:225-272-0100
Practice Address - Fax:225-272-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 14009251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1020052Medicaid