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General NPI Number Information
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NPI Number | 1124382882
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Entity Type | Organization
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Legal Business Name | INSPIRATIONAL CARE COORDINATION SERVICES,LLC
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 3402 BAKER BLVD SUITE A-3
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City | BAKER
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State | LA
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Zip | 70714-2509
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Country | US
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Telephone | 225-302-5577
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Fax | 225-302-5578
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Provider Business Mailing Address
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Address Line | 3402 BAKER BLVD SUITE A-3
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City | BAKER
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State | LA
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Zip | 70714-2509
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Country | US
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Telephone | 225-302-5577
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Fax | 225-302-5578
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Authorized Official
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Title or Position | EXECUTIVE/DIRECTOR
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Name | TAJA RANEE HAMILTON
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Credential |
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Telephone | 225-302-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 27072
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License Number State | LA
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