| Home With Grace | |
|
217 Rue Louis Xiv Ste 100 Lafayette LA 70508-5778 | |
| (337) 366-2293 | |
| (337) 948-9200 |
| Full Name | Home With Grace |
|---|---|
| Speciality | Clinic/center |
| Location | 217 Rue Louis Xiv Ste 100, Lafayette, Louisiana |
| Authorized Official Name and Position | Timothy Bergeron (CEO) |
| Authorized Official Contact | 3373662293 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home With Grace 217 Rue Louis Xiv Ste 100 Lafayette LA 70508-5778 Ph: (337) 366-2293 | Home With Grace 217 Rue Louis Xiv Ste 100 Lafayette LA 70508-5778 Ph: (337) 366-2293 |
| NPI Number | 1730707506 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 08/18/2020 |
| Certification Date | 08/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730707506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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