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General NPI Number Information
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NPI Number | 1215071147
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Entity Type | Organization
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Legal Business Name | PRIDE AND HOPE MINISTRY FAMILY SUPPORT
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 30208 HIGHWAY 21
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City | ANGIE
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State | LA
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Zip | 70426-4360
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Country | US
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Telephone | 985-732-9494
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Fax | 985-261-7045
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Provider Business Mailing Address
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Address Line | 25502 HWY 21
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City | ANGIE
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State | LA
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Zip | 70426
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Country | US
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Telephone | 985-732-9494
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Fax | 985-732-9615
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | MRS. MYRA N MAGEE
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Credential |
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Telephone | 985-732-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 11896
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 11891
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License Number State | LA
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