Provider Demographics
NPI: | 1497995146 |
---|---|
Name: | ARENA SITTING SERVICE PCA,LLC |
Entity Type: | Organization |
Organization Name: | ARENA SITTING SERVICE PCA,LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHEIF EXECUTIVE OFFICER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | SHIRLEY |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | OSBORNE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPN |
Authorized Official - Phone: | 504-889-8380 |
Mailing Address - Street 1: | 3814 VETERANS BLVD. |
Mailing Address - Street 2: | STE. #202 |
Mailing Address - City: | METAIRIE |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70002 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 504-889-8380 |
Mailing Address - Fax: | 504-889-8390 |
Practice Address - Street 1: | 3814 VETERANS MEMORIAL BLVD. |
Practice Address - Street 2: | STE. #202 |
Practice Address - City: | METAIRIE |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70002 |
Practice Address - Country: | US |
Practice Address - Phone: | 504-889-8380 |
Practice Address - Fax: | 504-889-8390 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-02-20 |
Last Update Date: | 2009-02-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PCA15180 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |