Provider Demographics
NPI:1649588765
Name:INTENSIVE HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:INTENSIVE HOME HEALTHCARE, INC.
Other - Org Name:INTENSIVE HOME HEALTHCARE AND HOSPICE OF LOUISIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:ELVESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-336-9030
Mailing Address - Street 1:1633 CARTER STREET
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-3110
Mailing Address - Country:US
Mailing Address - Phone:318-336-9030
Mailing Address - Fax:318-336-9497
Practice Address - Street 1:1633 CARTER STREET
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3110
Practice Address - Country:US
Practice Address - Phone:318-336-9030
Practice Address - Fax:318-336-9497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTENSIVE HOME HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1135251E00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health