Healthcare Provider Details
I. General information
NPI: 1215987441
Provider Name (Legal Business Name): CORRECT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
229 SAINT JOHN LN
COVINGTON LA
70433
US
IV. Provider business mailing address
229 SAINT JOHN LN
COVINGTON LA
70433-3276
US
V. Phone/Fax
- Phone: 985-773-1847
- Fax: 985-249-5618
- Phone: 985-773-1847
- Fax: 985-249-5618
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EDWARD
JACKSON
DEASE
III
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 985-249-5600