Healthcare Provider Details

I. General information

NPI: 1629493770
Provider Name (Legal Business Name): RAPIDES PEDIATRIC DAY HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 INDUSTRIAL ST
ALEXANDRIA LA
71301
US

IV. Provider business mailing address

3212 INDUSTRIAL ST
ALEXANDRIA LA
71301
US

V. Phone/Fax

Practice location:
  • Phone: 318-448-0449
  • Fax:
Mailing address:
  • Phone: 318-448-0449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number2203781968
License Number StateLA

VIII. Authorized Official

Name: MANDY WILLIAMSON
Title or Position: OWNER
Credential:
Phone: 318-448-0449