Healthcare Provider Details

I. General information

NPI: 1003024712
Provider Name (Legal Business Name): ADVANCED PERSONAL CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 CAROL SUE AVE STE 6
GRETNA LA
70056-4124
US

IV. Provider business mailing address

1800 CAROL SUE AVE STE 6
GRETNA LA
70056-4124
US

V. Phone/Fax

Practice location:
  • Phone: 504-227-0773
  • Fax: 504-227-0715
Mailing address:
  • Phone: 504-227-0773
  • Fax: 504-227-0715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberPCA12187
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEATRA MONIQUE MATTHEWS
Title or Position: CEO
Credential:
Phone: 504-227-0773