Provider Demographics
NPI:1518106418
Name:HOME-CARE PCA, LLC
Entity Type:Organization
Organization Name:HOME-CARE PCA, LLC
Other - Org Name:HOME-CARE PCA DAY DEVELOPMENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-651-6263
Mailing Address - Street 1:185 BELLE TERRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3349
Mailing Address - Country:US
Mailing Address - Phone:985-651-6263
Mailing Address - Fax:985-651-6465
Practice Address - Street 1:185 BELLE TERRE BLVD
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3349
Practice Address - Country:US
Practice Address - Phone:985-651-6263
Practice Address - Fax:985-651-6465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1343463Medicaid