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NPI Code Detail

MEDICARE: D NICOLE, LLC

MEDICARE: D NICOLE, 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
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1760182513
Entity Type Code : Organization
Provider Name (Legal Business Name) : D NICOLE, LLC
Provider Business Mailing Address
First Line : 330 OAK HARBOR BLVD STE B
Second Line :
City : SLIDELL
State : LA
Zip : 70458-5703
Country : US
Telephone Number : 833-733-1333
Fax Number :
Provider Business Practice Location Address
First Line : 330 OAK HARBOR BLVD STE B
Second Line :
City : SLIDELL
State : LA
Zip : 70458-5703
Country : US
Telephone Number : 833-733-1333
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. DONDRA N HILLS
Credential :
Telephone Number : 504-296-1030
Provider Enumeration Date : 03/08/2023
Last Update Date : 03/08/2023

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Directions to “D NICOLE, LLC ” Practice Location

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