Healthcare Provider Details

I. General information

NPI: 1194875302
Provider Name (Legal Business Name): AT PEOPLE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12A WESTBANK EXPRESSWAY STE 204
GRETNA LA
70053
US

IV. Provider business mailing address

12A WESTBANK EXPRESSWAY STE 204
GRETNA LA
70053
US

V. Phone/Fax

Practice location:
  • Phone: 504-362-4866
  • Fax: 504-362-4868
Mailing address:
  • Phone: 504-362-4866
  • Fax: 504-362-4868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number12048
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number12048
License Number StateLA

VIII. Authorized Official

Name: MR. ERIC DION MATTHEWS
Title or Position: DIRECTOR
Credential:
Phone: 504-362-4866