Provider Demographics
NPI:1578275996
Name:EGAN AT HOME LLC
Entity Type:Organization
Organization Name:EGAN AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LASKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-834-9996
Mailing Address - Street 1:3621 RIDGELAKE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1739
Mailing Address - Country:US
Mailing Address - Phone:504-834-9996
Mailing Address - Fax:504-399-9902
Practice Address - Street 1:3621 RIDGELAKE DR STE 300
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1739
Practice Address - Country:US
Practice Address - Phone:504-834-9996
Practice Address - Fax:504-399-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1461636Medicaid
LA1461393Medicaid