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General NPI Number Information
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NPI Number | 1174017461
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Entity Type | Organization
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Legal Business Name | ASSISI HOUSE, INC.
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 1120 GOVERNMENT ST
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City | BATON ROUGE
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State | LA
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Zip | 70802-4802
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Country | US
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Telephone | 225-395-1936
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Fax |
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Provider Business Mailing Address
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Address Line | 9936 E CARMEL CT
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City | BATON ROUGE
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State | LA
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Zip | 70818-3115
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Country | US
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Telephone | 225-395-1936
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Fax |
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Authorized Official
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Title or Position | FOUNDING DIRECTOR
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Name | DR. LESLIE GROVER
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Credential |
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Telephone | 225-395-1936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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