Provider Demographics
NPI:1992716823
Name:MEDICAL/HEALTHCARE ENTERPRISES INTERNATIONAL, INC.
Entity type:Organization
Organization Name:MEDICAL/HEALTHCARE ENTERPRISES INTERNATIONAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:M
Authorized Official - Last Name:BORDELON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-226-8202
Mailing Address - Street 1:3117 HWY 71
Mailing Address - Street 2:
Mailing Address - City:CAMPTI
Mailing Address - State:LA
Mailing Address - Zip Code:71411
Mailing Address - Country:US
Mailing Address - Phone:318-527-0104
Mailing Address - Fax:318-527-0108
Practice Address - Street 1:3117 HWY 71
Practice Address - Street 2:
Practice Address - City:CAMPTI
Practice Address - State:LA
Practice Address - Zip Code:71411
Practice Address - Country:US
Practice Address - Phone:318-527-0104
Practice Address - Fax:318-527-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1401706Medicaid
LA197170Medicare Oscar/Certification