Organization
PARISHES SUPPORTIVE LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COREY ANTOINE VINING (CFO)
(985) 386-0898
Entity
Organization
Contact information
Practice address
112 S 3RD ST, PONCHATOULA, LA 70454-2602
(985) 370-5787
(985) 370-5788
Mailing address
112 S 3RD ST, PONCHATOULA, LA 70454-2602
(985) 370-5787
(985) 370-5788
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154318
CC-PONCHATOULA
LA
01
—
1173487
LTC-PONCHATOULA
LA
01
—
1184004
PCA-PONCHATOULA
LA
01
—
1186775
SIL-PONCHATOULA
LA
01
—
1454176
SIL-LULING
LA
01
—
1465658
LTC-KENNER
LA
01
—
1526568
PCA-LULING
LA
01
—
1622338
LTC-BR
LA
01
—
1627879
CC-BR
LA
01
—
1723436
PCA-KENNER
LA
01
—
1723924
PCA-BR
LA
01
—
1725293
SIL-KENNER
LA
01
—
1731048
SIL-BR
LA
01
—
1743411
LTC-LULING
LA
Enumeration date
05/04/2007
Last updated
08/22/2020
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