Provider Demographics
NPI:1952718934
Name:HOMETOWN SENIOR CARE LLC
Entity Type:Organization
Organization Name:HOMETOWN SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:225-218-4389
Mailing Address - Street 1:9121 INTERLINE AVE STE 10A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1973
Mailing Address - Country:US
Mailing Address - Phone:225-218-4389
Mailing Address - Fax:225-218-6388
Practice Address - Street 1:9121 INTERLINE AVE STE 10A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1973
Practice Address - Country:US
Practice Address - Phone:225-218-4389
Practice Address - Fax:225-218-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782413253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care