Provider Demographics
NPI:1487830568
Name:PERSONAL CARE SERVICES 2000, LLC
Entity Type:Organization
Organization Name:PERSONAL CARE SERVICES 2000, LLC
Other - Org Name:PERSONAL CARE SERVICES 2000 LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-562-1140
Mailing Address - Street 1:1901 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8915
Mailing Address - Country:US
Mailing Address - Phone:337-562-1140
Mailing Address - Fax:337-562-1142
Practice Address - Street 1:1835 OAK PARK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8999
Practice Address - Country:US
Practice Address - Phone:337-430-0245
Practice Address - Fax:337-990-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 11776311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1462705Medicaid