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General NPI Number Information
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NPI Number | 1467324517
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Entity Type | Organization
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Legal Business Name | DFAC3 LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1500 LAFAYETTE ST STE 123
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City | GRETNA
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State | LA
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Zip | 70053-5732
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Country | US
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Telephone | 504-688-1019
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 LAFAYETTE ST STE 123
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City | GRETNA
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State | LA
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Zip | 70053-5732
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Country | US
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Telephone | 504-688-1019
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LASHONDRA MARSHALL
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Credential |
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Telephone | 504-209-1906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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