# IMMACULATE HEART OF MARY-PCS LLC

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

## Provider details

- **NPI number:** 1669652855
- **Authorized official:** BENNETT MORAIN (OWNER)
- **Authorized official phone:** (225) 694-3312

## Contact information

- **Practice address:** 241 NORTH LA 1, MORGANZA, LA 70759
- **Practice address phone:** (225) 694-3312
- **Practice address fax:** (225) 694-0337
- **Mailing address:** PO BOX 505, MORGANZA, LA 70759-0505
- **Mailing address phone:** (225) 694-3312
- **Mailing address fax:** (225) 694-0337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 372600000X | Adult Companion | — | NULL | Yes |
| 372600000X | Adult Companion | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 06/18/2008