Provider Demographics
NPI:1124340187
Name:REGIONAL PCA SERVICES - CENTRAL, LLC
Entity type:Organization
Organization Name:REGIONAL PCA SERVICES - CENTRAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-928-8989
Mailing Address - Street 1:3600 JACKSON STREET EXT
Mailing Address - Street 2:SUITE 111
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3040
Mailing Address - Country:US
Mailing Address - Phone:318-448-9064
Mailing Address - Fax:318-448-9065
Practice Address - Street 1:3600 JACKSON STREET EXT
Practice Address - Street 2:SUITE 111
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3040
Practice Address - Country:US
Practice Address - Phone:318-448-9064
Practice Address - Fax:318-448-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15298253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care