MEDICARE: D & M PERSONAL CARE ATTENDANT SERVICE, 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	3747P1801X	Personal Care Attendant	10507	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366465239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D & M PERSONAL CARE ATTENDANT SERVICE, LLC

Provider Business Mailing Address
First Line	:	6014 LANIER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-2312
Country	:	US
Telephone Number	:	225-357-9824
Fax Number	:	225-357-9824

Provider Business Practice Location Address
First Line	:	6014 LANIER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-2312
Country	:	US
Telephone Number	:	225-357-9824
Fax Number	:	225-357-9824

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MRS. LINDA MARIE TERRANCE
Credential	:	RN
Telephone Number	:	225-357-9822

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	02/18/2008

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