Provider Demographics
NPI:1366654964
Name:LOUISIANA HUMAN CARE CONNECTION INC
Entity Type:Organization
Organization Name:LOUISIANA HUMAN CARE CONNECTION INC
Other - Org Name:LA HUMAN CARE CONNECTION INC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ETTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-778-2477
Mailing Address - Street 1:P O BOX 1065
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70704
Mailing Address - Country:US
Mailing Address - Phone:225-778-2477
Mailing Address - Fax:225-774-3388
Practice Address - Street 1:14012 CAYUGA DRIVE
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714
Practice Address - Country:US
Practice Address - Phone:225-778-2477
Practice Address - Fax:225-774-3388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14766763747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1468762Medicaid