Organization
TAILORED CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE JO BRUCE RN (PRESIDENT)
(504) 368-1512
Entity
Organization
Contact information
Practice address
1799 STUMPF BLVD, BLDG 5 STE 1, TERRYTOWN, LA 70056-3950
(504) 368-1512
Mailing address
1405 MAPLEWOOD DR, HARVEY, LA 70058-3809
(504) 368-6483
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
PCA 8682
LA
251C00000X
Developmentally Disabled Services Day Training Agency
RC 8681
LA
251C00000X
Developmentally Disabled Services Day Training Agency
SIL 8683
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1435597
—
LA
05
—
1435619
—
LA
05
—
1472107
—
LA
Enumeration date
07/25/2007
Last updated
07/25/2007
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