Healthcare Provider Details

I. General information

NPI: 1114473691
Provider Name (Legal Business Name): 'YOUR FAMILY CASEMANGEMENTSERVICES LLC'
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 DESIARD PLAZA DR 115
MONROE LA
71203-4959
US

IV. Provider business mailing address

350 DESIARD PLAZA DR 115
MONROE LA
71203-4959
US

V. Phone/Fax

Practice location:
  • Phone: 318-651-2106
  • Fax:
Mailing address:
  • Phone: 318-651-2106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MIN KATIE B DUKE
Title or Position: OWNER
Credential:
Phone: 318-651-2106