# TRADITIONS HEALTH CARE OF PONCHATOULA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Traditions Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861073389
- **Authorized official:** DAVID KLEMENTZ (PRESIDENT & CEO)
- **Authorized official phone:** (979) 704-6547

## Contact information

- **Practice address:** 1579 HIGHWAY 51, PONCHATOULA, LA 70454-6374
- **Practice address phone:** (985) 386-7800
- **Mailing address:** 150 4TH AVE N STE 2300, NASHVILLE, TN 37219-2466
- **Mailing address phone:** (979) 704-6457

## Taxonomy

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

## Other

- **Enumeration date:** 04/16/2021
- **Last updated:** 09/21/2023