Provider Demographics
NPI:1013500552
Name:SLR HOLDINGS LLC
Entity Type:Organization
Organization Name:SLR HOLDINGS LLC
Other - Org Name:GULFSOUTH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-256-5599
Mailing Address - Street 1:PO BOX 3370
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70434-3370
Mailing Address - Country:US
Mailing Address - Phone:985-256-5599
Mailing Address - Fax:985-256-5687
Practice Address - Street 1:1970 N HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5364
Practice Address - Country:US
Practice Address - Phone:985-256-5599
Practice Address - Fax:985-256-5687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GULFSOUTH HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-16
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty