Provider Demographics
NPI:1740247709
Name:SKILLS HOME HEALTHCARE INC
Entity type:Organization
Organization Name:SKILLS HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BANKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:225-201-8913
Mailing Address - Street 1:9405 INTERLINE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-201-8913
Mailing Address - Fax:225-201-8917
Practice Address - Street 1:9405 INTERLINE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-201-8913
Practice Address - Fax:225-201-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA503251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1404217Medicaid
LA503OtherSTATE OF LA
LA503OtherSTATE OF LA