MEDICARE: AFFILIATION PLUS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1134350390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFILIATION PLUS LLC

Provider Business Mailing Address
First Line	:	14923 MEMORIAL TOWER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-8396
Country	:	US
Telephone Number	:	225-978-7897
Fax Number	:

Provider Business Practice Location Address
First Line	:	717 S FOSTER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-5943
Country	:	US
Telephone Number	:	225-978-7897
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. SONYA L WILLIAMS
Credential	:
Telephone Number	:	225-078-7897

Provider Enumeration Date	:	08/05/2009
Last Update Date	:	08/05/2009

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Directions to “AFFILIATION PLUS LLC ” Practice Location

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