Provider Demographics
NPI:1912041286
Name:EXCELLENT HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:EXCELLENT HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:DELAINEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-362-9207
Mailing Address - Street 1:1821 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-3404
Mailing Address - Country:US
Mailing Address - Phone:504-362-9207
Mailing Address - Fax:504-362-9209
Practice Address - Street 1:1821 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3404
Practice Address - Country:US
Practice Address - Phone:504-362-9207
Practice Address - Fax:504-362-9209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA305251E00000X
251J00000X, 251X00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1402290Medicaid
LA1912041286OtherPEOPLE'S HEALTH
LA197240Medicare ID - Type Unspecified