Provider Demographics
NPI:1720842537
Name:ALLEGIANCE HOME HEALTH OF SOUTH LOUISIANA LLC
Entity Type:Organization
Organization Name:ALLEGIANCE HOME HEALTH OF SOUTH LOUISIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDELON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-226-8202
Mailing Address - Street 1:233 W LAUREL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535
Mailing Address - Country:US
Mailing Address - Phone:337-576-2978
Mailing Address - Fax:337-576-2979
Practice Address - Street 1:233 W LAUREL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535
Practice Address - Country:US
Practice Address - Phone:337-576-2978
Practice Address - Fax:337-576-2979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health