Individual
JIREIA MCCELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2211 WEYMOUTH DR STE B, BATON ROUGE, LA 70809-2017
(225) 923-3733
(225) 923-3735
Mailing address
2211 WEYMOUTH DR STE B, BATON ROUGE, LA 70809-2017
(225) 923-3733
(225) 923-3735
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600964601
—
LA
Enumeration date
05/12/2021
Last updated
09/08/2021
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