Provider Demographics
NPI:1467763854
Name:EXQUISITE HOME CARE LLC
Entity Type:Organization
Organization Name:EXQUISITE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-251-0493
Mailing Address - Street 1:2312 N HARPER DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-1334
Mailing Address - Country:US
Mailing Address - Phone:504-251-0493
Mailing Address - Fax:
Practice Address - Street 1:5640 READ BLVD STE 220
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-7805
Practice Address - Country:US
Practice Address - Phone:504-244-0455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40178639K261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center