Provider Demographics
NPI:1386100410
Name:ANCHOR OF HOPE
Entity type:Organization
Organization Name:ANCHOR OF HOPE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-275-1616
Mailing Address - Street 1:107 S LAKE ARTHUR AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-5766
Mailing Address - Country:US
Mailing Address - Phone:337-275-1616
Mailing Address - Fax:
Practice Address - Street 1:1011 N LAKE ARTHUR AVE UNIT B
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4631
Practice Address - Country:US
Practice Address - Phone:337-246-3931
Practice Address - Fax:337-246-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health