Provider Demographics
NPI:1598986358
Name:ALLIED HEALTH CARE, L.L.C.
Entity Type:Organization
Organization Name:ALLIED HEALTH CARE, L.L.C.
Other - Org Name:38TH STREET COMMUNITY HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-445-6470
Mailing Address - Street 1:PO BOX 8055
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71306-1055
Mailing Address - Country:US
Mailing Address - Phone:504-445-6470
Mailing Address - Fax:
Practice Address - Street 1:2204 38TH ST
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3518
Practice Address - Country:US
Practice Address - Phone:504-443-4098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1718912Medicaid