=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063303493
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORE CARE PEDIACTRICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2025
-----------------------------------------------------
Last Update Date | 07/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10084 S CHOCTAW DRIVE SUITE B
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-255-2429
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13379 BELLE REINE DR
-----------------------------------------------------
City | GEISMAR
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70734-3381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-324-5201
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | DORIS HAMMOND
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 225-255-2429
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------