# MALICORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093984353
- **Authorized official:** MARY ALICE FUSELIER (C.E.O.)
- **Authorized official phone:** (318) 574-2229

## Contact information

- **Practice address:** 722 JOHNSON ST, TALLULAH, LA 71282-4533
- **Practice address phone:** (318) 574-2229
- **Practice address fax:** (318) 574-2219
- **Mailing address:** 722 JOHNSON ST, TALLULAH, LA 71282-4533
- **Mailing address phone:** (318) 574-2229
- **Mailing address fax:** (318) 574-2219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 02/20/2008