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General NPI Number Information
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NPI Number | 1043907991
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Entity Type | Organization
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Legal Business Name | MSGR. DEBLANC - DAUGHTERS OF MARY MOTHER OF MERCY JOY CARE CENTER
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 425 7TH ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-6006
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Country | US
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Telephone | 862-371-5775
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Fax |
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Provider Business Mailing Address
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Address Line | 425 7TH ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-6006
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Country | US
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Telephone | 862-371-5775
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Fax |
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Authorized Official
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Title or Position | ASSISTANT MANAGER OR
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Name | CHIBUJUM EJIOCHI SR.
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Credential | REGISTERED NURSE
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Telephone | 337-496-6575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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