Healthcare Provider Details

I. General information

NPI: 1356778815
Provider Name (Legal Business Name): FRIENDS FOREVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 WEATHER RD
RINGGOLD LA
71068-2651
US

IV. Provider business mailing address

209 WEATHER RD
RINGGOLD LA
71068-2651
US

V. Phone/Fax

Practice location:
  • Phone: 318-894-2564
  • Fax:
Mailing address:
  • Phone: 318-894-2564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELA D MOORE
Title or Position: OWNER
Credential:
Phone: 318-894-2564