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Organization
EASTERSEALS
Active
Organization
EASTERSEALS
Active
Other names
Easterseals
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRELISA S BRIDGEWATER (PSR)
(318) 820-7219
Entity
Organization
Contact information
Practice address
5411 FAIRFAX AVE, SHREVEPORT, LA 71108-3342
(318) 820-7219
Mailing address
5411 FAIRFAX AVE, SHREVEPORT, LA 71108-3342
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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