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General NPI Number Information
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NPI Number | 1164128211
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Entity Type | Organization
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Legal Business Name | INFINITE HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 66 BAYOU VIEW DR
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City | MONROE
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State | LA
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Zip | 71203-2732
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Country | US
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Telephone | 318-812-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 66 BAYOU VIEW DR
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City | MONROE
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State | LA
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Zip | 71203-2732
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Country | US
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Telephone | 318-812-4565
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MS. LALISA WADE
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Credential | DNP
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Telephone | 318-812-4565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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