Healthcare Provider Details

I. General information

NPI: 1982043287
Provider Name (Legal Business Name): LIBERTY SIX COMMUNITY HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1582 HWY 190 WEST
EUNICE LA
70535
US

IV. Provider business mailing address

P.O. BOX 1287
EUNICE LA
70535
US

V. Phone/Fax

Practice location:
  • Phone: 337-546-0667
  • Fax: 337-546-6827
Mailing address:
  • Phone: 337-546-0667
  • Fax: 337-546-6827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number2528
License Number StateLA

VIII. Authorized Official

Name: MR. FRANKIE LAFLEUR JR
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 337-546-0667