Provider Demographics
NPI:1407993033
Name:HOME-CARE PCA, INC.
Entity Type:Organization
Organization Name:HOME-CARE PCA, INC.
Other - Org Name:A-ABSOLUTE HOME-CARE PCA, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-446-3377
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-0004
Mailing Address - Country:US
Mailing Address - Phone:985-446-3377
Mailing Address - Fax:985-446-7766
Practice Address - Street 1:353 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70302-0004
Practice Address - Country:US
Practice Address - Phone:985-446-3377
Practice Address - Fax:985-446-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA10443251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1169790Medicaid