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General NPI Number Information
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NPI Number | 1740741388
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Entity Type | Organization
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Legal Business Name | MARY LEES HOUSE OF LOVE ADULT DAY HEALTHCARE
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 403 CHURCH STREET
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City | MELVILLE
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State | LA
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Zip | 71353
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Country | US
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Telephone | 337-623-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 403 CHURCH STREET
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City | MELVILLE
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State | LA
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Zip | 71353
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Country | US
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Telephone | 337-623-4411
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EUGENIA WASHINGTON
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Credential |
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Telephone | 337-623-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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