Provider Demographics
NPI:1306037932
Name:AMEDISYS SP-IN, L.L.C.
Entity Type:Organization
Organization Name:AMEDISYS SP-IN, L.L.C.
Other - Org Name:AMEDISYS HOME HEALTH OF TERRE HAUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:4134 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4123
Practice Address - Country:US
Practice Address - Phone:812-234-1850
Practice Address - Fax:812-232-5689
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMEDISYS SP-IN, L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-08
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060049261251E00000X
IN13-004926-1251E00000X
IN15-004926-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200836910BMedicaid
IN200836910BMedicaid