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General NPI Number Information
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NPI Number | 1164275384
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Entity Type | Individual
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Provider Name | LAURA HELLEN NEELY
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Gender | Female
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 350 E ST STE 403
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City | EUREKA
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State | CA
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Zip | 95501-0352
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Country | US
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Telephone | 707-496-8499
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Fax | 707-497-6777
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Provider Business Mailing Address
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Address Line | PO BOX 6888
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City | EUREKA
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State | CA
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Zip | 95502-6888
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Country | US
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Telephone | 707-496-8499
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Fax | 707-497-6777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 124700001
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License Number State | CA
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