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General NPI Number Information
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NPI Number | 1447524087
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Entity Type | Organization
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Legal Business Name | BETTY JOE'S COMPANION CARE, LLC
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 24460 HIGHWAY 430
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City | FRANKLINTON
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State | LA
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Zip | 70438-2614
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Country | US
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Telephone | 985-795-9934
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Fax |
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Provider Business Mailing Address
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Address Line | 24460 HIGHWAY 430 P O BOX 247
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City | FRANKLINTON
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State | LA
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Zip | 70438-2614
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Country | US
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Telephone | 985-795-9934
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. GYNDLYNN W MAGEE
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Credential |
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Telephone | 985-795-9934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | LA
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