Provider Demographics
NPI:1659508307
Name:HENRY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:HENRY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEITHA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-382-5607
Mailing Address - Street 1:6176 BOUTTE ST
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3527
Mailing Address - Country:US
Mailing Address - Phone:504-382-5607
Mailing Address - Fax:504-340-0283
Practice Address - Street 1:5128 LAPALCO BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4249
Practice Address - Country:US
Practice Address - Phone:504-340-0288
Practice Address - Fax:504-340-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20173253Z00000X
LAPCA 15242253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care