Provider Demographics
NPI:1346011400
Name:THE H2O EXPERIENCE INC
Entity Type:Organization
Organization Name:THE H2O EXPERIENCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. OF OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:225-312-3931
Mailing Address - Street 1:3940 PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-5143
Mailing Address - Country:US
Mailing Address - Phone:225-312-3931
Mailing Address - Fax:
Practice Address - Street 1:3940 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-5143
Practice Address - Country:US
Practice Address - Phone:225-312-3931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)