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General NPI Number Information
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NPI Number | 1093765273
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Entity Type | Organization
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Legal Business Name | ENTRUM CARE INC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 6235 HIGHWAY 157
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City | HAUGHTON
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State | LA
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Zip | 71037-7647
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Country | US
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Telephone | 318-949-1828
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Fax | 318-949-1825
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Provider Business Mailing Address
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Address Line | 6235 HIGHWAY 157 PO BOX 1265
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City | HAUGHTON
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State | LA
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Zip | 71037-7647
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Country | US
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Telephone | 318-949-1828
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Fax | 318-949-1825
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIE FULLER
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Credential | CMA, MA, MBA
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Telephone | 318-949-1828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1621447
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License Number State | LA
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