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General NPI Number Information
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NPI Number | 1770146987
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Entity Type | Organization
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Legal Business Name | NORTH TANGI ADULT DAY CARE
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 1005 NW CENTRAL AVE
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City | AMITE
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State | LA
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Zip | 70422-5723
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Country | US
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Telephone | 985-247-2509
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Fax | 985-247-2509
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Provider Business Mailing Address
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Address Line | 45246 MORRIS RD
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City | HAMMOND
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State | LA
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Zip | 70401-7816
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Country | US
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Telephone | 985-507-2573
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Fax | 985-247-2509
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHIRLEY D HENDRICKS
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Credential | RN
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Telephone | 985-507-2573
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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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