Provider Demographics
NPI:1780831479
Name:CM HOMECARE
Entity Type:Organization
Organization Name:CM HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:BRAZZEL
Authorized Official - Last Name:SPEYRER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-447-4669
Mailing Address - Street 1:4726 HIGHWAY 107 S
Mailing Address - Street 2:
Mailing Address - City:PLAUCHEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71362-2312
Mailing Address - Country:US
Mailing Address - Phone:318-447-4669
Mailing Address - Fax:
Practice Address - Street 1:4726 HIGHWAY 107 S
Practice Address - Street 2:
Practice Address - City:PLAUCHEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71362-2312
Practice Address - Country:US
Practice Address - Phone:318-447-4669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health