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General NPI Number Information
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NPI Number | 1881318103
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Entity Type | Organization
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Legal Business Name | LA HOLD SERVICES LLC
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 3222 GLENMONT RIDGE CT
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City | FRESNO
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State | TX
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Zip | 77545-8776
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Country | US
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Telephone | 510-954-3798
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Fax |
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Provider Business Mailing Address
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Address Line | 3222 GLENMONT RIDGE CT
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City | FRESNO
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State | TX
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Zip | 77545-8776
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Country | US
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Telephone | 510-954-3798
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURITA DIXON
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Credential |
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Telephone | 815-703-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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