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19D2016328 CLIA NUMBER - INTENSIVE HOME HEALTHCARE AND HOSPICE OF LOUISIANA INTENSIVE HOME HEALTHCARE, INC

Laboratory Demographics

CLIA Number: 19D2016328

Facility Name: INTENSIVE HOME HEALTHCARE AND HOSPICE OF LOUISIANA INTENSIVE HOME HEALTHCARE, INC

Facility Address:
1633 CARTER STREET
VIDALIA, LA
ZIP 71373
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Facility Phone Number: 318 336-9030

Facility Type: Hospice

Certificate Type: Waiver
NPI Number: 1134167349

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 19D2016328
LAB Type Hospice
Facility Name INTENSIVE HOME HEALTHCARE AND HOSPICE OF LOUISIANA INTENSIVE HOME HEALTHCARE, INC
Street 1633 CARTER STREET
City VIDALIA
State LA
ZIP 71373
Phone 318 336-9030
CertificateType 4
CertificateEffectiveDate 11/16/2022
CertificateExpirationDate 11/15/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024