Healthcare Provider Details

I. General information

NPI: 1396969887
Provider Name (Legal Business Name): ACTIVITIES OF DAILY LIVING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 RICHARD ST
BREAUX BRIDGE LA
70517-6039
US

IV. Provider business mailing address

400 RICHARD ST
BREAUX BRIDGE LA
70517-6039
US

V. Phone/Fax

Practice location:
  • Phone: 337-332-1810
  • Fax: 337-332-3300
Mailing address:
  • Phone: 337-332-1810
  • Fax: 337-332-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. STELLA WILTZ
Title or Position: DIRECTOR OF SERVICES
Credential: OWNER
Phone: 337-332-1810