Healthcare Provider Details

I. General information

NPI: 1598981037
Provider Name (Legal Business Name): A AND L OF NORTHEAST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 W MAIN ST C
HOMER LA
71040-3300
US

IV. Provider business mailing address

PO BOX 9425
MONROE LA
71211-9425
US

V. Phone/Fax

Practice location:
  • Phone: 318-927-4215
  • Fax: 318-927-4265
Mailing address:
  • Phone: 318-325-5221
  • Fax: 318-325-5227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number1122726
License Number StateLA

VIII. Authorized Official

Name: AUGUSTA TURNER
Title or Position: CEO
Credential:
Phone: 318-325-5221