Provider Demographics
NPI:1124319603
Name:DEQUINCY HOME HEALTH INC
Entity type:Organization
Organization Name:DEQUINCY HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-786-1210
Mailing Address - Street 1:500 S GRAND AVE
Mailing Address - Street 2:PO BOX 1095
Mailing Address - City:DEQUINCY
Mailing Address - State:LA
Mailing Address - Zip Code:70633-4122
Mailing Address - Country:US
Mailing Address - Phone:337-786-4400
Mailing Address - Fax:
Practice Address - Street 1:500 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:DEQUINCY
Practice Address - State:LA
Practice Address - Zip Code:70633-4122
Practice Address - Country:US
Practice Address - Phone:337-786-4400
Practice Address - Fax:337-786-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based