Provider Demographics
NPI:1821066218
Name:CMB HOME CARE, INC
Entity Type:Organization
Organization Name:CMB HOME CARE, INC
Other - Org Name:KEY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:POWELL
Authorized Official - Last Name:CAMBRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN OWNER PRES
Authorized Official - Phone:985-549-1539
Mailing Address - Street 1:16030 LAMONTE DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1404
Mailing Address - Country:US
Mailing Address - Phone:985-549-1539
Mailing Address - Fax:985-549-1577
Practice Address - Street 1:16030 LAMONTE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1404
Practice Address - Country:US
Practice Address - Phone:985-549-1539
Practice Address - Fax:985-549-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA861251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1406171Medicaid
LA1406171Medicaid