Provider Demographics
NPI:1881121747
Name:STAT HOME HEALTH SOUTHEAST LOUISIANA LLC
Entity type:Organization
Organization Name:STAT HOME HEALTH SOUTHEAST LOUISIANA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-368-3181
Mailing Address - Street 1:10615 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-7230
Mailing Address - Country:US
Mailing Address - Phone:225-368-3181
Mailing Address - Fax:
Practice Address - Street 1:19184 DR JOHN LAMBERT DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-0935
Practice Address - Country:US
Practice Address - Phone:985-652-7248
Practice Address - Fax:985-652-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3711940Medicaid