Organization
CD&J MANAGEMENT, LLC
Active
Other names
Optimum Personal Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELILAH MOUTON BROUSSARD (EXECUTIVE DIRECTOR)
(337) 593-8444
Entity
Organization
Contact information
Practice address
920 W PINHOOK RD, SUITE 226, LAFAYETTE, LA 70503-2455
(337) 593-8444
(337) 593-9966
Mailing address
920 W PINHOOK RD, SUITE 226, LAFAYETTE, LA 70503-2455
(337) 593-8444
(337) 593-9966
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
11117
LA
305R00000X
Preferred Provider Organization
12067
LA
305R00000X
Preferred Provider Organization
12068
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466093
—
LA
05
—
1776785
—
LA
05
—
1778371
—
LA
Enumeration date
04/04/2007
Last updated
08/22/2020
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