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Organization
ABIDING IN THE VINE CARE PROVIDER
Active
Organization
ABIDING IN THE VINE CARE PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY MARIE CHRISTOPHER (DIRECTOR)
(504) 267-0322
Entity
Organization
Contact information
Practice address
1141 WHITNEY AVE BLDG 2, GRETNA, LA 70056-5011
(504) 267-0322
(504) 265-0153
Mailing address
1141 WHITNEY AVE BLDG 2, GRETNA, LA 70056-5011
(504) 267-0322
(504) 265-0153
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
04/18/2018
Last updated
08/23/2019
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