Provider Demographics
NPI:1326667320
Name:LAGNIAPPE HOME AND COMMUNITY CARE LLC
Entity Type:Organization
Organization Name:LAGNIAPPE HOME AND COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:BUSH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:337-849-7431
Mailing Address - Street 1:102 RAPHAEL DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5952
Mailing Address - Country:US
Mailing Address - Phone:337-541-0219
Mailing Address - Fax:
Practice Address - Street 1:102 RAPHAEL DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5952
Practice Address - Country:US
Practice Address - Phone:337-541-0219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1306843Medicaid