Provider Demographics
NPI:1629273404
Name:IBC NURSING SERVICES, INC
Entity Type:Organization
Organization Name:IBC NURSING SERVICES, INC
Other - Org Name:IBC MANAGEMENT DBA IBC GROUP DBA IBC PERSONAL CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-857-2580
Mailing Address - Street 1:PO BOX 930
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-0930
Mailing Address - Country:US
Mailing Address - Phone:337-857-2580
Mailing Address - Fax:337-857-2579
Practice Address - Street 1:327 IBERIA ST UNIT 5
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5738
Practice Address - Country:US
Practice Address - Phone:337-857-2580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA8677251E00000X
LASIL10328251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1507091Medicaid
LA1432032Medicaid
LA1460516Medicaid
LA1166065Medicaid