Provider Demographics
NPI:1477585214
Name:CAPITAL HEALTH SERVICES MID REGION LOUISIANA
Entity Type:Organization
Organization Name:CAPITAL HEALTH SERVICES MID REGION LOUISIANA
Other - Org Name:LIVINGSTON HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-791-7921
Mailing Address - Street 1:8369 FLORIDA BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-7862
Mailing Address - Country:US
Mailing Address - Phone:225-791-7921
Mailing Address - Fax:
Practice Address - Street 1:8369 FLORIDA BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7862
Practice Address - Country:US
Practice Address - Phone:225-791-7921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1020364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty