Provider Demographics
NPI:1659556033
Name:PERSONAL CARE SERVICE OF CARENCRO LLC
Entity Type:Organization
Organization Name:PERSONAL CARE SERVICE OF CARENCRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEARLIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:FLUGENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-886-3073
Mailing Address - Street 1:403 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-3520
Mailing Address - Country:US
Mailing Address - Phone:337-886-3073
Mailing Address - Fax:337-886-1413
Practice Address - Street 1:403 VETERANS DR
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-3520
Practice Address - Country:US
Practice Address - Phone:337-886-3073
Practice Address - Fax:337-886-1413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSONAL CARE SERVICE OF CARENCRO,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-04
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health