Organization
WISDOM HEALTHCARE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY L LANDRY (CEO)
(337) 230-3116
Entity
Organization
Contact information
Practice address
109 BOULET DR, LAFAYETTE, LA 70506-2212
(337) 279-2102
(337) 735-1887
Mailing address
5520 JOHNSON STE K PMB 1121, LAFAYETTE, LA 70503-6706
(337) 279-2102
(337) 735-1887
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
12/27/2021
Last updated
04/05/2024
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