Provider Demographics
NPI:1285199513
Name:BONCARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:BONCARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLEY
Authorized Official - Middle Name:A A
Authorized Official - Last Name:JANSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-655-8329
Mailing Address - Street 1:3100 RIDGELAKE DRIVE
Mailing Address - Street 2:#306
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-444-6144
Mailing Address - Fax:
Practice Address - Street 1:3100 RIDGELAKE DRIVE
Practice Address - Street 2:#306
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-444-6144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty