Organization
COMPANION CARE OF SOUTHWEST LOUISIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WALLACE (OWNER)
(337) 404-4045
Entity
Organization
Contact information
Practice address
407 B NORTH 5TH STREET, LEESVILLE, LA 70634
(337) 404-4045
(337) 404-4066
Mailing address
407 B NORTH 5TH STREET, LEESVILLE, LA 70634
(337) 404-4045
(337) 404-4066
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
2203782335
LA
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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