Provider Demographics
NPI:1194006619
Name:REGIONAL PCA SERVICES - BATON ROUGE, LLC
Entity type:Organization
Organization Name:REGIONAL PCA SERVICES - BATON ROUGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:LANPHIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-928-8989
Mailing Address - Street 1:8352 BLUEBONNET BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2825
Mailing Address - Country:US
Mailing Address - Phone:225-928-8989
Mailing Address - Fax:225-928-8990
Practice Address - Street 1:8352 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2825
Practice Address - Country:US
Practice Address - Phone:225-928-8989
Practice Address - Fax:225-928-8990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL PCA - GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 15328253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care