Provider Demographics
NPI:1154593515
Name:HOME-CARE PCA, LLC
Entity type:Organization
Organization Name:HOME-CARE PCA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-446-3377
Mailing Address - Street 1:P.O. BOX 179
Mailing Address - Street 2:353 W. MAIN ST.
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-0004
Mailing Address - Country:US
Mailing Address - Phone:985-446-3377
Mailing Address - Fax:985-446-7766
Practice Address - Street 1:5235 FLORIDA ST. SUITE-E
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-0004
Practice Address - Country:US
Practice Address - Phone:225-927-7730
Practice Address - Fax:225-927-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7201251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1001368Medicaid