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General NPI Number Information
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NPI Number | 1386189652
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Entity Type | Organization
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Legal Business Name | J. ALLEN INVESTMENTS LLC.
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 42573 PLEASANT RIDGE ROAD EXT
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City | PONCHATOULA
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State | LA
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Zip | 70454-4764
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Country | US
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Telephone | 318-415-8872
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Fax |
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Provider Business Mailing Address
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Address Line | 137 PENN MILL LAKES BLVD
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City | COVINGTON
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State | LA
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Zip | 70435-0574
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JAJUAN ALLEN
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Credential |
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Telephone | 318-415-8872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 558499
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 558499
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License Number State | LA
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