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General NPI Number Information
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NPI Number | 1144754128
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Entity Type | Organization
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Legal Business Name | WILKINSON CARE GIVING LLC
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 18314 S I 12 SERVICE RD
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City | PONCHATOULA
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State | LA
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Zip | 70454-4710
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Country | US
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Telephone | 985-429-0119
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Fax | 985-340-0119
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Provider Business Mailing Address
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Address Line | 18314 SOUTH I-12 SERVICE ROAD
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City | PONCHATOULA
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State | LA
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Zip | 70454
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Country | US
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Telephone | 985-429-0119
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Fax | 985-340-0119
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | ALICIA WILKINSON
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Credential |
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Telephone | 985-429-0119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2203782738
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License Number State | LA
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