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General NPI Number Information
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NPI Number | 1811101298
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Entity Type | Organization
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Legal Business Name | PERRYL HEALTH SERVICES
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1417 CENTER ST
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City | NEW IBERIA
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State | LA
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Zip | 70560
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Country | US
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Telephone | 337-256-8567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11137
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City | NEW IBERIA
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State | LA
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Zip | 70560
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Country | US
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Telephone | 337-256-8567
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. PERRY W ANTOINE JR.
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Credential |
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Telephone | 337-256-8567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | PCA 6780
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License Number State | LA
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