MEDICARE: GIFT OF DELIVERANCE, L.L.C.

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1467853762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFT OF DELIVERANCE, L.L.C.

Provider Business Mailing Address
First Line	:	20432 LULLABYE LN
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-4104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20432 LULLABYE LN
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-4104
Country	:	US
Telephone Number	:	985-507-7684
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CYRESIA GIBSON
Credential	:
Telephone Number	:	985-507-7684

Provider Enumeration Date	:	09/06/2014
Last Update Date	:	09/06/2014

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