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General NPI Number Information
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NPI Number | 1972763811
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Entity Type | Organization
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Legal Business Name | SEASONS HEALTH CARE SERVICES, LLC
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 311 E AIRPORT AVE STE D
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City | BATON ROUGE
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State | LA
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Zip | 70806-4840
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Country | US
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Telephone | 225-218-6803
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Fax |
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Provider Business Mailing Address
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Address Line | 311 E AIRPORT AVE STE D
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City | BATON ROUGE
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State | LA
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Zip | 70806-4840
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Country | US
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Telephone | 225-218-6803
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. VERONICA GRAY
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Credential |
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Telephone | 225-218-6803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | PCA 15049
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License Number State | LA
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