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General NPI Number Information
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NPI Number | 1912374604
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Entity Type | Organization
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Legal Business Name | PINNACLE FAMILY SERVICES OF LOUISIANA, LLC
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 2902 EVANGELINE ST
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City | MONROE
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State | LA
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Zip | 71201-3724
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Country | US
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Telephone | 318-651-8264
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Fax |
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Provider Business Mailing Address
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Address Line | 2902 EVANGELINE ST
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City | MONROE
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State | LA
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Zip | 71201-3724
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Country | US
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Telephone | 318-651-8264
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Fax |
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Authorized Official
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Title or Position | STATE DIRECTOR
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Name | MRS. DANA CASTINE
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Credential |
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Telephone | 318-651-8264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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