Provider Demographics
NPI:1699150961
Name:1ST TRADITIONS HOMECARE LLC
Entity type:Organization
Organization Name:1ST TRADITIONS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DJOUFFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-416-0409
Mailing Address - Street 1:19527 CYPRIATE TRL
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5843
Mailing Address - Country:US
Mailing Address - Phone:713-416-0409
Mailing Address - Fax:
Practice Address - Street 1:19527 CYPRIATE TRL
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5843
Practice Address - Country:US
Practice Address - Phone:713-416-0409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health