# EASTERSEALS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Easterseals
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962937623
- **Authorized official:** MS. TRELISA S BRIDGEWATER (PSR)
- **Authorized official phone:** (318) 820-7219

## Contact information

- **Practice address:** 5411 FAIRFAX AVE, SHREVEPORT, LA 71108-3342
- **Practice address phone:** (318) 820-7219
- **Mailing address:** 5411 FAIRFAX AVE, SHREVEPORT, LA 71108-3342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2017
- **Last updated:** 05/01/2017