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NPI Code Detail

MEDICARE: BODY & SOUL SERVICES, INC.

MEDICARE: BODY & SOUL SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578727566
Entity Type Code : Organization
Provider Name (Legal Business Name) : BODY & SOUL SERVICES, INC.
Provider Business Mailing Address
First Line : 5743 MER ROUGE RD
Second Line :
City : BASTROP
State : LA
Zip : 71220-9765
Country : US
Telephone Number : 318-283-3299
Fax Number : 318-283-3298
Provider Business Practice Location Address
First Line : 5743 MER ROUGE RD
Second Line :
City : BASTROP
State : LA
Zip : 71220-9765
Country : US
Telephone Number : 318-283-3299
Fax Number : 318-283-3298
Authorized Official
Title or Position : VICE-PRESIDENT
Name : DERENDA FLOWERS
Credential :
Telephone Number : 318-376-1113
Provider Enumeration Date : 07/18/2008
Last Update Date : 06/27/2024

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Directions to “BODY & SOUL SERVICES, INC. ” Practice Location

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