Provider Demographics
NPI:1063597029
Name:FIRST OPTION HOME HEALTH, INC.
Entity type:Organization
Organization Name:FIRST OPTION HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT, COO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:G
Authorized Official - Last Name:KINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:337-235-9741
Mailing Address - Street 1:4906 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6916
Mailing Address - Country:US
Mailing Address - Phone:337-235-9741
Mailing Address - Fax:337-234-1294
Practice Address - Street 1:4906 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6916
Practice Address - Country:US
Practice Address - Phone:337-235-9741
Practice Address - Fax:337-234-1294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA452251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA34449OtherBLUE CROSS
LA1403440Medicaid
LA34449OtherBLUE CROSS