Provider Demographics
NPI:1871580415
Name:HOMECARE RESOURCES, LLC
Entity type:Organization
Organization Name:HOMECARE RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NOBLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLINGTON
Authorized Official - Suffix:III
Authorized Official - Credentials:RN
Authorized Official - Phone:318-435-3342
Mailing Address - Street 1:1707 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-2939
Mailing Address - Country:US
Mailing Address - Phone:318-435-3342
Mailing Address - Fax:318-435-5191
Practice Address - Street 1:1707 WARREN ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2939
Practice Address - Country:US
Practice Address - Phone:318-435-3342
Practice Address - Fax:318-435-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA992251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1403024Medicaid
LA1403024Medicaid