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General NPI Number Information
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NPI Number | 1083827901
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Entity Type | Organization
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Legal Business Name | CHRISTIANFOUNDATIONINC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 266 MYRTLE GROVE ST
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City | DONALDSONVILLE
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State | LA
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Zip | 70346-4340
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Country | US
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Telephone | 122-547-4545
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Fax | 122-547-4548
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Provider Business Mailing Address
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Address Line | 266 MYRTLE GROVE ST
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City | DONALDSONVILLE
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State | LA
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Zip | 70346-4340
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Country | US
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Telephone | 122-547-4545
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Fax | 122-547-4548
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARILYN ANN WARR
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Credential | NURSE
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Telephone | 12254745475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 10679
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License Number State | LA
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