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General NPI Number Information
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NPI Number | 1558522961
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Entity Type | Organization
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Legal Business Name | NEAL W.ANGRUM
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 200 WASHINGTON ST SUITE 1-E
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City | MONROE
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State | LA
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Zip | 71201-6757
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Country | US
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Telephone | 318-450-1478
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Fax | 318-388-6893
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Provider Business Mailing Address
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Address Line | 408 THATCHER LN
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City | MONROE
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State | LA
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Zip | 71203-6516
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Country | US
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Telephone | 318-450-1478
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. NEAL W ANGRUM
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Credential |
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Telephone | 318-450-1478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 0007691
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License Number State | LA
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