Provider Demographics
NPI:1942250592
Name:COMPREHENSIVE HOME HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HOME HEALTHCARE SERVICES LLC
Other - Org Name:AMEDISYS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:123 N 19TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2865
Practice Address - Country:US
Practice Address - Phone:606-248-1062
Practice Address - Fax:606-248-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150129251B00000X, 251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0000000077741OtherBLUE CROSS PROVIDER ID
KY0002748OtherCHA HEALTH PROVIDER ID
KY45345642Medicaid
KY7100126150Medicaid
KY7100163150Medicaid
KY42620013Medicaid
KY347620070Medicaid
KY000000077741OtherKY ACCESS PROVIDER ID
KY34620070Medicaid
KY7100163110Medicaid
KY0000000077741OtherBLUE CROSS PROVIDER ID