Healthcare Provider Details

I. General information

NPI: 1841466091
Provider Name (Legal Business Name): MAGIC TOUCH HEALING HANDS.COM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 W PARC GREEN ST
HARVEY LA
70058
US

IV. Provider business mailing address

3420 W PARC GREEN
HARVEY LA
70058
US

V. Phone/Fax

Practice location:
  • Phone: 504-376-1865
  • Fax:
Mailing address:
  • Phone: 504-376-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateLA

VIII. Authorized Official

Name: MS. CHERYL KELLER BERGERON
Title or Position: ONWER CEO
Credential:
Phone: 504-376-1865