Provider Demographics
NPI:1164401881
Name:LOUISA HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:LOUISA HOME CARE SERVICES LLC
Other - Org Name:THREE RIVERS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GACHASSIN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-443-4154
Practice Address - Street 1:306 COMMERCE DR
Practice Address - Street 2:STE 400
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-5063
Practice Address - Country:US
Practice Address - Phone:606-638-0521
Practice Address - Fax:606-638-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150169251E00000X, 251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100110350Medicaid
KY34001644Medicaid
KY42010645Medicaid