Provider Demographics
NPI:1609844596
Name:LAGNIAPPE HOMECARE NORTHERN LOUISANA INC
Entity Type:Organization
Organization Name:LAGNIAPPE HOMECARE NORTHERN LOUISANA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSITRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-628-3807
Mailing Address - Street 1:206 N BEVILL ST
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-3231
Mailing Address - Country:US
Mailing Address - Phone:318-628-3807
Mailing Address - Fax:318-628-3818
Practice Address - Street 1:206 N BEVILL ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3231
Practice Address - Country:US
Practice Address - Phone:318-628-3807
Practice Address - Fax:318-628-3818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA245251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1401978Medicaid
LA1401978Medicaid