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Organization
IMMACULATE HEART OF MARY-PCS LLC
Active
Organization
IMMACULATE HEART OF MARY-PCS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENNETT MORAIN (OWNER)
(225) 694-3312
Entity
Organization
Contact information
Practice address
241 NORTH LA 1, MORGANZA, LA 70759
(225) 694-3312
(225) 694-0337
Mailing address
PO BOX 505, MORGANZA, LA 70759-0505
(225) 694-3312
(225) 694-0337
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NULL
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/06/2007
Last updated
06/18/2008
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