Provider Demographics
NPI:1467838995
Name:SALUS HOME CARE, LLC
Entity Type:Organization
Organization Name:SALUS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:228-207-2515
Mailing Address - Street 1:13109 SHRINERS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-8747
Mailing Address - Country:US
Mailing Address - Phone:228-207-2515
Mailing Address - Fax:888-704-7978
Practice Address - Street 1:13109 SHRINERS BLVD STE B
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-8747
Practice Address - Country:US
Practice Address - Phone:228-207-2515
Practice Address - Fax:888-704-7978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle