Healthcare Provider Details

I. General information

NPI: 1679762421
Provider Name (Legal Business Name): THE CARING CLINIC OF LOUISIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 NORTH BLVD SUITE 115
BATON ROUGE LA
70806-4013
US

IV. Provider business mailing address

4550 NORTH BLVD SUITE 115
BATON ROUGE LA
70806-4013
US

V. Phone/Fax

Practice location:
  • Phone: 225-341-5901
  • Fax: 225-341-5903
Mailing address:
  • Phone: 225-341-5901
  • Fax: 225-341-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY J. YOUNG
Title or Position: ADMINISTRATOR
Credential:
Phone: 225-341-5901