Organization
MARIE'S FAMILY HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATILDA JOHNSON (OWNER)
(318) 574-9009
Entity
Organization
Contact information
Practice address
111 N WALNUT ST, TALLULAH, LA 71282-3733
(318) 574-9009
Mailing address
111 N WALNUT ST, TALLULAH, LA 71282-3733
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1151360
—
LA
Enumeration date
05/09/2013
Last updated
05/09/2013
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