Healthcare Provider Details

I. General information

NPI: 1649585365
Provider Name (Legal Business Name): ADULT DAY HEALTH CARE OF LIVINGSTON PARISH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 FLORIDA AVE SUITE 2
DENHAM SPRINGS LA
70726-4914
US

IV. Provider business mailing address

2011 FLORIDA AVE SUITE 2
DENHAM SPRINGS LA
70726-4914
US

V. Phone/Fax

Practice location:
  • Phone: 225-665-5893
  • Fax: 225-304-6333
Mailing address:
  • Phone: 225-665-5893
  • Fax: 225-304-6333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHELIA WILSON
Title or Position: PRESIDENT
Credential: MSN, RN
Phone: 225-665-5893