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Organization
MANGHAM HOME CARE
Active
Organization
MANGHAM HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IDA GILLEY (ADMINISTRATOR)
(318) 248-2849
Entity
Organization
Contact information
Practice address
714 BROADWAY STREET, MANGHAM, LA 71259
(318) 248-2849
(318) 248-2852
Mailing address
P,O. BOX 427, MANGHAM, LA 71259
(318) 248-2849
(318) 248-2852
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCA 10355
LA
Other
Enumeration date
02/19/2008
Last updated
07/02/2008
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