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General NPI Number Information
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NPI Number | 1073801049
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Entity Type | Organization
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Legal Business Name | FAMILY CARE GIVING
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 108 CEDAR LN
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City | SLIDELL
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State | LA
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Zip | 70460-6212
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Country | US
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Telephone | 985-774-1844
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Fax | 985-288-5027
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Provider Business Mailing Address
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Address Line | 108 CEDAR LN
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City | SLIDELL
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State | LA
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Zip | 70460-6212
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Country | US
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Telephone | 985-774-1844
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Fax | 985-288-5027
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TONYA DEVILLIER
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Credential | PCP
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Telephone | 985-774-1844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 10171342#83C42
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License Number State | LA
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