Provider Demographics
NPI:1942483227
Name:EDWARDS' PERSONAL CARE ATTENDANT SERVICES, L.L.C.
Entity Type:Organization
Organization Name:EDWARDS' PERSONAL CARE ATTENDANT SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IDA
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-671-1693
Mailing Address - Street 1:7505 PINES RD
Mailing Address - Street 2:SUITE 1185
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-3935
Mailing Address - Country:US
Mailing Address - Phone:318-688-1418
Mailing Address - Fax:318-688-1419
Practice Address - Street 1:7505 PINES RD
Practice Address - Street 2:SUITE 1185
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3935
Practice Address - Country:US
Practice Address - Phone:318-688-1418
Practice Address - Fax:318-688-1419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 14066251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health