Organization
MARTIN FAMILY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHINKESHA C TAYLOR (DIRECTOR)
(318) 326-4623
Entity
Organization
Contact information
Practice address
248 BLANKENSHIP, 248 BLANKENSHIP, PLAIN DEALING, LA 71064
(318) 326-4623
Mailing address
248 BLANKENSHIP ROAD, PLAIN DEALING, LA 71064
(318) 326-4623
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
15079
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15079
—
LA
Enumeration date
09/04/2008
Last updated
09/04/2008
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