Organization
MEDICAL MALL HEALTH SERVICES OF LOUISIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD WILLIAMS (OWNER)
(225) 806-6923
Entity
Organization
Contact information
Practice address
3745 CHOCTAW DR, BATON ROUGE, LA 70805-8333
(225) 806-6923
(225) 372-8105
Mailing address
3745 CHOCTAW DR, BATON ROUGE, LA 70805-8333
(225) 806-6923
(225) 372-8105
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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