Healthcare Provider Details

I. General information

NPI: 1528615770
Provider Name (Legal Business Name): ALLEN & RILEY HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 06/04/2023
Certification Date: 06/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E JOLLIET CT
LA PLACE LA
70068-7155
US

IV. Provider business mailing address

501 RUE DE SANTE STE 1
LA PLACE LA
70068-5400
US

V. Phone/Fax

Practice location:
  • Phone: 504-418-3351
  • Fax: 985-233-4046
Mailing address:
  • Phone: 985-233-4063
  • Fax: 985-233-4046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JESSTINA ALLEN
Title or Position: CEO
Credential:
Phone: 504-418-3351