Provider Demographics
NPI:1730187972
Name:CENTRAL HOME HEALTH, LLC
Entity type:Organization
Organization Name:CENTRAL HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:504-455-5959
Mailing Address - Street 1:2805 ATHANIA PKWY
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5905
Mailing Address - Country:US
Mailing Address - Phone:504-455-5959
Mailing Address - Fax:504-455-8997
Practice Address - Street 1:2805 ATHANIA PKWY STE B
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5905
Practice Address - Country:US
Practice Address - Phone:504-455-5959
Practice Address - Fax:504-455-8997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1008251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19-7779Medicare UPIN
19-7779Medicare UPIN
LA19-7779Medicare ID - Type UnspecifiedHOME HEALTH CARE