Provider Demographics
NPI:1427337872
Name:LEE ANN'S PERSONAL CARE SERVICE INC
Entity type:Organization
Organization Name:LEE ANN'S PERSONAL CARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAGGENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-687-8137
Mailing Address - Street 1:57835 HAASE ST
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3329
Mailing Address - Country:US
Mailing Address - Phone:225-687-8137
Mailing Address - Fax:
Practice Address - Street 1:57835 HAASE ST
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3329
Practice Address - Country:US
Practice Address - Phone:225-687-8137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14041253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care