Healthcare Provider Details

I. General information

NPI: 1316389539
Provider Name (Legal Business Name): R & J LECLERC ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15354 TERRELL RD
BATON ROUGE LA
70816-9026
US

IV. Provider business mailing address

15354 TERRELL RD
BATON ROUGE LA
70816-9026
US

V. Phone/Fax

Practice location:
  • Phone: 225-252-2393
  • Fax: 225-751-1547
Mailing address:
  • Phone: 225-252-2393
  • Fax: 225-751-1547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number552810
License Number StateLA

VIII. Authorized Official

Name: RONALD M LECLERC
Title or Position: MANAGING MEMBER
Credential:
Phone: 225-252-2393