Provider Demographics
NPI:1922463124
Name:HOLMES, DECARLOS (MHP)
Entity Type:Individual
Prefix:
First Name:DECARLOS
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MHP
Other - Prefix:
Other - First Name:DECARLOS
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHP
Mailing Address - Street 1:327 LAFITTE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70094-3327
Mailing Address - Country:US
Mailing Address - Phone:318-957-9644
Mailing Address - Fax:
Practice Address - Street 1:1995 GENTILLY BLVD STE C400
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-1700
Practice Address - Country:US
Practice Address - Phone:318-957-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator