Provider Demographics
NPI:1104210897
Name:PERSONAL CARE PARTNERS LLC
Entity Type:Organization
Organization Name:PERSONAL CARE PARTNERS LLC
Other - Org Name:DIVINE INSPIRATION PERSONAL CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-309-2160
Mailing Address - Street 1:3536 HOLIDAY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-8301
Mailing Address - Country:US
Mailing Address - Phone:504-309-2160
Mailing Address - Fax:504-309-2960
Practice Address - Street 1:3536 HOLIDAY DR
Practice Address - Street 2:SUITE B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-8301
Practice Address - Country:US
Practice Address - Phone:504-309-2160
Practice Address - Fax:504-309-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782236253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1011363Medicaid