Provider Demographics
NPI:1114114402
Name:UNITED HOME SERVICES
Entity Type:Organization
Organization Name:UNITED HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WARFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-329-9090
Mailing Address - Street 1:213 EXPO CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-9495
Mailing Address - Country:US
Mailing Address - Phone:318-329-9264
Mailing Address - Fax:318-329-1048
Practice Address - Street 1:213 EXPO CIR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-9495
Practice Address - Country:US
Practice Address - Phone:318-329-9090
Practice Address - Fax:318-329-1048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-01
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA10475251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1172022Medicaid